Effects of Flipped Classroom Combined with Game-Based Learning on Learning Achievement and Satisfaction Among Nursing Students in Nursing Care for Children with Urinary Tract Disorders
Article Sidebar
Main Article Content
Abstract
Objective: To examine the effects of a flipped classroom combined with game-based Learning on the learning achievement and satisfaction of nursing students regarding the topic of nursing care for children with urinary tract disorders. Methods: This study utilized a quasi-experimental research design with a one-group pretest-posttest approach. The sample consisted of 103 third-year nursing students. The research instruments consisted of eight parts including a learning management manual, self-learning materials, game scoring forms, learning game kits, question cards, a demographic questionnaire, a pretest and post-test, and a satisfaction questionnaire. The content validity of instruments was evaluated by three experts. The question cards and the pretest and post-test had Item-Objective Congruence (IOC) values of .96 and 1.00, respectively. The satisfaction questionnaire had content validity index (CVI) value of .96 and a reliability coefficient, with a Cronbach’s alpha of .91. Data were analyzed using descriptive statistics and a paired t-test. Results: After the intervention, the participants' mean post-test score was significantly higher than the pre-test score (t = -12.18, p < .001). The overall satisfaction was at the highest level (M = 4.67, SD = .56). Specifically, the promotion of teamwork skills (M = 4.83, SD = .47) and the enjoyment of the teaching method (M = 4.82, SD = .46) received the highest ratings. Conclusion: The implementation of flipped classroom learning combined with game-based learning resulted in students achieving higher post-test scores than pre-test scores and reported learning satisfaction. Therefore, this instructional method can be effectively applied in pediatric nursing courses.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
Office of the Education Council. National scheme of education B.E. 2560-2579 (2017-2036). Bangkok: Office of the Education Council, Ministry of Education; 2017.
Li BZ, Cao NW, Ren CX, et al. Flipped classroom improves nursing students' theoretical learning in China: a meta-analysis. PLoS One. 2020; 15(8): e0237926. doi: 10.1371/journal.pone.0237926.
Orias DJZ, Adante LBT, Catungal FG. Revolutionizing nursing education: problem-based learning vs. traditional methods for higher-order thinking: a systematic review. Int J Multidiscip Res. 2025; 7(2): 1-8.
Pivac S, Skela-Savic B, Jovic D, et al. Implementation of active learning methods by nurse educators in undergraduate nursing students' programs - a group interview. BMC Nurs. 2021; 20(1): 173. doi: 10.1186/s12912-021-00688-y.
Ahmady S, Hashemi HZ, Afra A, et al. Games to improve the clinical skills of nursing students: systematic review of current evidence. Asian Pac Isl Nurs J. 2025; 9(1): e70737.
Mehrdad M, Jambarsang S, Sadeghian H, et al. Effects of game-based learning and flipped classroom strategies on performance and reasoning in patient safety education for surgical nursing students. PLoS One. 2025; 20(10): e0334545. doi:10.1371/journal.pone.0334545.
Limvong T, Saengri Y. Flipped classroom: new learning for 21st century skills. Mahidol R2R e-Journal. 2019; 6(2): 9-17. doi:10.14456/jmu.2019.10. Thai.
Hew KF, Lo CK. Flipped classroom improves student learning in health professions education: a meta-analysis. BMC Med Educ. 2018; 18(1): 38.
Chang C, Hwang G. Trends in digital game-based learning in the mobile era: a systematic review of journal publications from 2007 to 2016. Int J Mob Learn Organ. 2019; 13(1): 68-90.
Celik F, Turan R, Bektas H. The effect of game-based interventions on the nursing students’ level of knowledge: A systematic review and meta-analysis of randomized controlled trials. Nurse Educ Today. 2025; 151: 106746. doi.org/10.1016/j.nedt.2025.106746
Choosang S, Chai-ngam N, Pongkiatchai R. Instructional design: Under the concept of game based learning for nursing education. JFHB. 2023; 16(1): 60-70.
Yuceyurt NK, Yaş MA. Game-based learning in nursing: a systematic review. BMC Med Educ. 2025; 26(1): 28. doi: 10.1186/s12909-025-08331-z.
Vazquez-Calatayud M, García-García R, Regaira-Martínez E, et al. Real-world and game-based learning to enhance decision-making. Nurse Educ Today. 2024; 140: 106276. doi: 10.1016/j.nedt.2024.106276.
Amran A, Jalil HA, Muhamad M, et al. Factors contributing to collaborative game-based learning (CGBL) effectiveness. Asian Social Science. 2021; 17(11): 1-17. doi: 10.5539/ass.v17n11p1.
Kumpanat T, Koonchayanggoon S, Punchaariyakun S, et al. Cognitive learning behavior based on the concept of Bloom’s revised taxonomy. J Grad Res. 2020; 11(2): 1-10. Thai.
Chantarajit C. Effects of flipped classroom and gamification to develop learning and innovation skills for education students Songkhla Rajabhat University. EJ-NSTRU. 2025; 4(2): e2673. Thai.
Pleekorn P, Sophonhiranrak S, Boonyarit I. The effects of learning management based-on flipped classrooms together with television game shows upon grade 12 students’ Thai language analytical thinking for further education entitled word formation. SIKKHA. 2020; 7(2): 11-19. Thai.
Vygotsky LS. Mind in society: the development of higher psychological processes. Cambridge (MA): Harvard University Press; 1978.
Sukontawat W, Khoyun S, Wongprakornkul S, et al. The development of the flipped classroom model in teaching and learning of adults nursing subject related urinary system. RDHSJ. 2021; 14(3): 140-151. Thai.
Maneejak N, Sukkapathanasrikul S, Chaoayachai W, et al. The effects of flipped classroom with Jeopardy game-based learning on nursing students’ learning and in-class behaviors in a fundamental nursing course. Nurs Sci J Thailand. 2022; 40(3): 105-119. Thai.
Bergmann J, Sams A. Flip your classroom – reach every student. Electron J Soc Strateg Stud. 2022; 3(2): 258-264. doi:10.47362/EJSSS.2022.3208.
Garris R, Ahlers R, Driskell JE. Games, motivation, and learning: a research and practice model. Simul Gaming. 2002; 33(4): 441-467. doi: 10.1177/1046878102238607.
Polit DF, Beck CT. Nursing research: generating and assessing evidence for nursing practice. 10th ed. Philadelphia (PA): Wolters Kluwer; 2017.
Giuliano CA, Moser LR. Evaluation of a flipped drug literature evaluation course. Am J Pharm Educ. 2016; 80(4): 1-8. doi: 10.5688/ajpe80466.
Seidel N. Short, long, and segmented learning videos: from YouTube practice to enhanced video players. Technol Knowl Learn. 2024; 29(4): 1965-1991. doi: 10.1007/s10758-024-09745-2.
Gudadappanavar AM, Benni JM, Javali SB. Effectiveness of the game-based learning over traditional teaching–learning strategy to instruct pharmacology for Phase II medical students. J Edu Health Promot 2021; 10: 91. doi: 10.4103/jehp.jehp_624_20
Thongpradab J, Lohacheewa S, Preeyanon L. Effects of game-based learning on nursing students’ knowledge of English psychiatry terminology. J Thailand Nurs Midwifery Counc. 2022; 37(4): 111-124.
Songprakun W, Yaowapanon N, Jaijoy K. Active learning for new generation nursing students: achieving competencies for newly graduated nurses. J Royal Thai Army Nurses. 2025; 26(1): 1-9. Thai.
Khorsuk C, Chaiwan V, Hankla S. The Effect of Cooperative Learning by using Teams-Games-Tournament method on Achievement in Maternal and Newborn Nursing Comprehension Subject of 4th Grade nurse students. Paper presented at: The 2019 Annual General Meeting and Academic Conference of The Nurses’ Association of Thailand, Northeastern Division; 2019 Sep 5-6; Nakhon Ratchasima, Thailand.
Chang YS, Hu SH, Kuo SW, et al. Effects of board game play on nursing students' medication knowledge: a randomized controlled trial. Nurse Educ Pract. 2022; 63:103412. doi: 10.1016/j.nepr.2022.103412.
Jongaramraung J, Santima P, Punyoo J, et al. Nursing students’ knowledge and satisfaction after receiving game-based learning. Nurs Res Inno J. 2024; 30(2): 239-252.
