Effectiveness of Digital Flipped Learning Evidence-Based Practice on Nurses’ Knowledge, Attitude, and Practice: A Quasi-Experimental Trial

Abstract

Background: Evidence-based care has become critical in raising the quality of medical facilities. The implementation of evidence-based practice helps medical practitioners make better clinical decisions. Objective: The objective of this study was to investigate whether the innovative flipped teaching model could be as effective as the conventional teaching model in terms of knowledge, attitude, and practice and to confirm the continuous effect. Design: A quasi-experimental design using the flipped and conventional learning groups concurrently with repeat measurements was used. Setting: The setting was a 475-bed regional teaching hospital in Taiwan, from March to July 2020. Participants: The study included 114 licensed nurses who had worked longer than three months, with 57 participants each in two groups. Methods: The participants were assigned to two groups using a block randomization method. All participants completed questionnaires related to knowledge, attitude, and practice of EBP at four-time points: pre-test (T0) and immediately after intervention (T1), at month 1 (T2), and at month 3 (T3). Analysis of repeated generalized estimating equations was used. Results: The flipped and conventional learning groups had significant differences in knowledge, attitude, and practice at the T0 and T1 (p < 0.05). The flipped group was higher than the conventional group at T3 in the knowledge score (p = 0.001) and lower than the conventional group at T2 in the attitude score (p = 0.010). There were no significant differences between the two groups’ practice scores at different time points. There were no significantly different score changes for knowledge, attitude, and practice (p > 0.05). The interaction term only at T3 vs. T0 in the knowledge score was slightly different (p = 0.049) in primary outcome. Conclusion: The intervention methods of both groups were effective. Flipped learning is more flexible and has more time for discussion, which nurses favor. Under the policy promoted in the hospital, EBP combined with the nursing advancement system was standardized, and conventional learning also improved the learning effect.

Exploring the potential impact of applying web-based training program on nurses’ knowledge, skills, and attitudes regarding evidence-based practice: A quasi-experimental study

“…This finding aligns with a study that showed a statistically significant improvement in nurses’ perceptions of EBP [ 46 ]. Additionally, our study’s results are consistent with those of Chao et al [ 41 ].…”

“…enhance healthcare workers' knowledge temporarily. Like the present study, [40][41][42][43]. Moreover, the current study found that nurses who took part in the web-based training program demonstrated improved EBP skills.…”

Comparing the Effectiveness of Two New CPR Training Methods in Korea: Medical Virtual Reality Simulation and Flipped Learning

“…In sum, our study and previous ones ( 3 , 5 , 20 – 22 ) show that medi-VR simulation and flipped learning can be used as effective interventional education for emergency care for cardiac arrest in the prehospital field. In particular, this study found that the medi-VR simulation method was superior to flipped learning in CPR performance.…”

“…Flipped learning-based intervention education among nursing students was effective for knowledge, attitude, and clinical practice immediately after intervention and even one month later compared with a conventional learning method ( 20 ). Moreover, after three months, the knowledge score was even higher, although the attitude score was lower than that in the conventional learning method.…”