It is essential for graduates of baccalaureate nursing programs to learn the concepts of research and evidence-based practice (American Association of Colleges of Nursing, 2008). However, many students are intimidated by this prospect and consider the language confusing, foreign, and boring. To combat these perceptions, faculty need to find creative ways to engage students in the learning process so concepts can be remembered and used in the future. One method of engaging students in the learning process is through the flipped classroom. Using this teaching methodology, students are required to prepare prior to class and to spend class time applying knowledge gained through the preparatory materials (Njie-Carr et al., 2017). When students come to class prepared with the basic knowledge of the content, faculty have the opportunity to guide students to a deeper level of knowledge. Limited examples exist for application activities in the research classroom. Journal clubs are useful ways to discuss research literature (Lachance, 2014) and provide a model to incorporate active teaching strategies into the classroom setting.
Several years ago, faculty teaching an undergraduate nursing research and evidence-based practice course noticed that students were not reading assigned chapters prior to class, did not seem engaged in course content, and inconsistently applied research concepts to written assignments. Although the active-learning strategy of an audience response system was used, students admittedly only guessed at answers. End-of-semester evaluations reflected the students' lack of understanding of the relevance of the course. Recognizing the need for change, the following goals were identified: (a) engage students in more effective active-learning strategies to improve achievement of learning outcomes and (b) teach using application-based strategies that foster learning.
To achieve these goals, the principles of the flipped classroom and journal clubs were incorporated into the course. Each week, journal articles from research literature are used to demonstrate course objectives. These articles are provided at the beginning of the course. Prior to class, students are expected to read course materials and assigned journal articles and complete preclass quizzes. Quiz questions cover information from the textbook and ask students to apply content to assigned articles to test understanding of content prior to arriving to class. Class time is spent applying course content to written assignments and published research. To reduce the number of articles students are required to read, the same articles are used several times throughout the semester to explain multiple concepts.
At the beginning of class, a short discussion is held as an overview of the material and questions are asked about assigned articles related to the content for the day. Questions change as course content becomes more difficult. Early in the semester, students are asked basic questions:
- What type of research article is this?
- What information tells you this?
Later, questions using the same published articles become more complex:
- How do you know this study is trustworthy?
- The author states this is an experimental study. Explain the details that make it experimental.
Students are encouraged to go beyond the title and abstract to discover answers to questions. Often, discussions are held on the article topic in addition to the research concepts. Article analysis is conducted through both small-group discussions (two to three students) and/or class discussions.
In preparation for examinations, new articles from published literature are provided the week prior to each test. This allows students time to evaluate the literature without the pressure of the examination setting. A clean copy of the article is given during the examination and short essay questions ask students to apply their new skills of critique. Examination questions are similar to those used in class. Grading is facilitated by looking for keywords in the student's answers to the essay questions.
As a result of this change, students are now more likely to come to class ready to engage in course content. Although grading takes longer, the answers to the essay questions provide more information regarding student knowledge than a multiple choice item would. Course evaluations reflect student appreciation of teaching using the articles as they feel these skills apply to future practice. This application-based teaching strategy can be used in both large- and small-group settings. Although this activity was used in a research classroom, it can be easily implemented in any classroom where published literature is available for critique. Students need strategies to help them to be successful as they apply course content, and these application-based teaching strategies have lasting implications as students become nurses who implement evidence-based practice.
Leann L. Laubach, PhD, RN
University of Central Oklahoma
- American Association of Colleges of Nursing. (2008). The essentials of baccalaureate education for professional nursing practice. Retrieved from http://www.aacnnursing.org/Portals/42/Publications/BaccEssentials08.pdf
- Lachance, C. (2014). Nursing journal clubs: A literature review on the effective teaching strategy for continuing education and evidence-based practice. The Journal of Continuing Education in Nursing, 45, 559–565. https://doi.org/10.3928/00220124-20141120-01 doi:10.3928/00220124-20141120-01 [CrossRef]
- Njie-Carr, V.P., Ludeman, E., Lee, M.C., Dordundoo, D., Trocky, N.M. & Jenkins, L.S. (2017). An integrative review of flipped classroom teaching models in nursing education. Journal of Professional Nursing, 33, 133–144. https://doi.org/10.1016/j.profnurs.2016.07.001 doi:10.1016/j.profnurs.2016.07.001 [CrossRef]