• Majeda M El-Banna, Malinda Whitlow, and Angela M McNelis.
• The George Washington University, School of Nursing, 45085 University Drive, Innovation Hall, Ashburn, VA 20147, USA. Electronic address: melbanna@gwu.edu.
• Nurse Educ Today. 2017 Sep 1; 56: 41-46.

BackgroundThe flipped classroom approach is based on shared responsibility for learning by students and teachers, and empowers students to take an active role in the learning process. While utilization of this approach has resulted in higher exam scores compared to traditional approaches in prior studies, the flipped classroom has not included learners in Accelerated Bachelor of Science in Nursing (ABSN) programs.ObjectiveTo examine differences on exam scores and satisfaction of teaching between a 3-week flipped and traditional classroom approach.DesignMixed methods, crossover repeated measures design.SettingsPrivate school of nursing located in the eastern United States.Participants76 ABSN students.MethodsTwo separate sections of a Pharmacology course received either 3-weeks of flipped or traditional classroom during Period 1, then switched approaches during Period 2. Two exam scores measuring knowledge and a questionnaire assessing satisfaction of teaching were collected. Focus groups were conducted to learn about students' experience in the flipped classroom. Descriptive statistics, Wilcoxon rank sum test, and stepwise linear mixed model were used to analyze quantitative data. Focus group data were transcribed, coded, and categorized in themes.ResultsStudents in the flipped classroom achieved significantly higher scores on the first Pharmacology exam than students in the traditional classroom, but there was no significant difference on the second exam. Three themes emerged from focus groups on student perception of integrating the flipped approach: don't fix what isn't broken; treat me as an adult; and remember the work is overwhelming.ConclusionsBoth traditional and flipped classroom approaches successfully prepared students for the Pharmacology exams. While results support the use of the flipped approach, judicious use of this instructional pedagogy with dense or difficult content, particularly in accelerated programs, is recommended. Instructors should also provide students with enough information and rationale for using the flipped classroom approach.Copyright © 2017 Elsevier Ltd. All rights reserved.

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