Background: Nursing educators need to be prepared to adopt innovative, evidence-based approaches to education to improve student learning outcomes and prepare the workforce- to better practice within complex health care systems. The present study aimed to determine the effect of simulation education based on flipped learning on performance, motivation in learning, and academic engagement of first-year undergraduate nursing students. Methods: This study was conducted with a quasi-experimental design. Forty first-year undergraduate nursing students registered for the spring semester were selected by whole enumeration sampling. For the intervention group (n=22), the fundamental nursing skills course was taught to them using simulation education based on flipped learning. The control group (n=18) was taught in the same class using simulation-based education. Outcomes, including performance, learning motivation, and academic engagement, were measured using the nursing skills observation checklists, the Instructional Materials Motivation Scale, and the academic engagement questionnaire at the middle and end of the semester. Data were analyzed using mean, paired t-test, and ANCOVA analysis with Stata-17 software. Result: There was no significant difference between the mean score performance and the total mean score of subscales of learning motivation and academic engagement in the middle and end of the semester in the two groups. Analysis of covariance (ANCOVA) showed no significant difference between the two groups in performance (P>0.05), learning motivation (P>0.05), and academic involvement (P>0.05). Conclusion: It is recommended to use this method as well as traditional approaches, particularly to teach psychomotor skills to senior students who have higher self-regulation skills. There is still a need for further research using this approach to teach psychomotor skills, practical lessons and various outcomes.
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