Long-term effects of flipped learning on nurses’ self-efficacy and satisfaction in pressure injury management: A multi-center quasi-experimental study

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Publicado no:Nurse Education in Practice vol. 85 (May 2025), p. 104368
Autor principal: Wen-Yi, Chao
Outros Autores: Wen-Chun, Liao
Publicado em:
Elsevier Limited
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022 |a 1471-5953 
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024 7 |a 10.1016/j.nepr.2025.104368  |2 doi 
035 |a 3203184348 
045 2 |b d20250501  |b d20250531 
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100 1 |a Wen-Yi, Chao  |u College of Nursing, Asia University, Taichung, Taiwan 
245 1 |a Long-term effects of flipped learning on nurses’ self-efficacy and satisfaction in pressure injury management: A multi-center quasi-experimental study 
260 |b Elsevier Limited  |c May 2025 
513 |a Journal Article 
520 3 |a Aims Investigate the long-term effects of a flipped education —based on adult learning theory and incorporating multimedia teaching and physical workshops—on nurses’ self-efficacy in preventing and managing pressure injuries. Background Pressure injuries remain a global challenge, requiring caregivers to blend theory with practice. Flipped learning has shown promise in boosting nurses' confidence and competence in managing these injuries through higher-level processes such as interaction, reflection, application, analysis and integration. Design A single-blind, multicenter, quasi-experimental, two-group parallel repeated-measures design was conducted in seven medical institutions. Method A total of 404 participants adopted an adult self-directed learning model. The control group received PDF-based materials, while the intervention group additionally underwent a flipped education program that combined multimedia teaching with physical workshops. Self-efficacy in the four domains—assessment, planning, monitoring and decision-making—was measured at baseline, immediately post-intervention and at one- and three-months post-intervention. Data were analyzed using descriptive statistics, chi-square tests, t-tests and generalized estimating equations. Results Following the intervention, both groups showed a significant increase in self-efficacy (p < .05). The intervention group scored higher in all domains, with improvements lasting three months and reported greater learning satisfaction. Conclusion Multimedia teaching enhances learners’ motivation and improves the effectiveness of adult self-directed learning. Physical workshops focused on higher-level analysis, integration and hands-on teaching further strengthened care confidence and self-efficacy. These findings confirm the effectiveness of flipped education in pressure injury education, especially regarding its long-term impact and offer valuable insights for designing future nursing training programs. 
653 |a Problem solving 
653 |a Intervention 
653 |a Collaboration 
653 |a Long term 
653 |a Wound healing 
653 |a Distance learning 
653 |a Pressure ulcers 
653 |a Flipped classroom 
653 |a Multimedia 
653 |a Motivation 
653 |a Participation 
653 |a Teaching 
653 |a Knowledge 
653 |a Educational materials 
653 |a Decision making 
653 |a Self-efficacy 
653 |a Independent study 
653 |a Nursing education 
653 |a Clinical medicine 
653 |a Adult learning 
653 |a Injuries 
653 |a Quasi-experimental methods 
653 |a Integrated care 
653 |a Nurses 
653 |a Caregivers 
653 |a Workshops 
653 |a Educational programs 
653 |a Prevention 
653 |a Computer platforms 
653 |a Adults 
653 |a Selfdirected learning 
653 |a Physical education 
653 |a Self evaluation 
653 |a Medical personnel 
653 |a Learning theories 
653 |a Learning 
653 |a Self instruction 
653 |a Satisfaction 
653 |a Nursing 
653 |a Statistics 
653 |a Groups 
653 |a Education 
653 |a Inservice Education 
653 |a Critical Thinking 
653 |a Adult Students 
653 |a Adult Basic Education 
653 |a Effect Size 
653 |a Instructional Effectiveness 
653 |a Decision Making Skills 
653 |a Course Content 
653 |a Learner Engagement 
653 |a Educational Strategies 
653 |a Brainstorming 
653 |a Competence 
653 |a Educational Resources 
653 |a Informed Consent 
653 |a Control Groups 
653 |a Educational Methods 
653 |a Learning Processes 
653 |a Electronic Learning 
653 |a Andragogy 
653 |a Classroom Communication 
653 |a Educational Facilities Improvement 
700 1 |a Wen-Chun, Liao  |u School of Nursing, China Medical University, Taichung, Taiwan; Department of Nursing, China Medical University Hospital, Taichung, Taiwan 
773 0 |t Nurse Education in Practice  |g vol. 85 (May 2025), p. 104368 
786 0 |d ProQuest  |t Sociology Database 
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