A B S T R A C TNursing students experience physiology as a challenging subject to learn. A learner-centred approach could enhance their learning. This study explored nursing students' experiences of actively studying anatomy and physiology off-campus within a flipped classroom using various digital tools. The data from focus group interviews and students' reflective notes were analysed using a combination of systematic text condensation and activity systems analysis. In the students' activity system, three tensions were identified: tension between students' expectations and the teaching design, tension between a wish for more frequent attendance and being on their own and tension between the schedule and time needed. The use of digital tools could have facilitated learning and preparation for the course activities. However, students seemed to depend on social assistance, and they might not be ready to take full responsibility for studying adequately by themselves.

Aims and objectives:To explore the on-campus activities of the flipped classroom and their role in nursing students' experiences of mastering physiology.Background: A nurse must be confident in their knowledge of physiology to feel confident as a nurse. However, many nursing students do not believe in their ability to master physiology. The flipped classroom design could facilitate active learning and promote students' confidence and competence in physiology. Design: A design-based research design was employed. Methods: Twenty-three nursing students enrolled in an anatomy and physiology course participated in two focus group interviews and wrote two individual reflective notes. The data were analysed by means of systematic text condensation and activity theory. Reporting was guided by the Consolidated Criteria for Reporting Qualitative Studies (COREQ). Results: The study findings underscore the importance of careful design of oncampus activities within the flipped classroom to support students' experiences of mastery in physiology. Four themes were identified: (a) preparation which builds a foundation for learning; (b) the use of digital tools; (c) learning through dialogue with peers; and (d) experience of the expected learning outcomes.Conclusions: On-campus learning activities within a flipped classroom design could support students' experiences of confidence in and mastery of physiology. However, the study participants found learner-centred activities challenging and described feeling doubtful of their ability to master physiology. A didactic framework could take into account the circumstance that students perceive educational technology differently. When designing on-campus activities, emphasis should be placed on collaboration rather than competition to help students develop confidence in their knowledge of physiology.

Digitisation has become a part of quality education and can help change the teacher's role from a lecturer to a supervisor, encourage a more student-centred approach, and increase the interactivity between the teacher and the students. However, it can be challenging to facilitate more interactive pedagogy in large classes. The aim of this study was to gain knowledge about nursing students' experience with the use of a student response system (SRS) in learning activities when learning physiology. This study was conducted at a university college in Norway, which offers Bachelor of Nursing degrees. In the Anatomy and Physiology course, a flipped classroom design, including the use of an SRS, was offered to nursing students. Data were collected in 2014 using focus group interviews with six students who were enrolled in the course and analysed using systematic text condensation. From this, four categories emerged describing the students' experiences with how the use of the SRS can support their learning: 1) creating a welcoming and stimulating learning environment, 2) encouraging participation in learning activities on campus, 3) facilitating collaboration on campus and 4) motivating students to study before and after on-campus meetings. The findings indicate that an SRS can be combined with different pedagogical strategies. Additionally, teachers should be aware of what kind of questions facilitate participation in polls versus those that are perceived as too challenging. New university college students studying within a flipped classroom design may struggle to prepare adequately before class meetings and need guidance from the teacher to handle both a new teaching approach and a new student role.

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