NURS 618 Week 3 Discussion Board Forum 1 on Active Learning in the Classroom Example

Discussion Board Forum 1: Moving From Lecture to Active Learning in a Nursing Classroom

NURS 618 Nurse Educator II: Teaching Strategies, Discussion Board Forum 1

Thread by [Student Name]

The course example and the classmates replied to are composites written for a model discussion.

Every semester, my preceptor's pharmacology students can list the mechanism, monitoring and antidote for warfarin, heparin and the direct oral anticoagulants. Then, in clinical, the same students struggle to decide whether to give a scheduled dose when the INR is 3.8 or a platelet count has fallen by half. The lecture taught them facts; it did not give them practice using the facts. My position for this forum is that nurse educators should flip at least part of their lecture content, moving the explanation to short materials students complete before class and spending class time on application.

Billings and Halstead (2016) describe active learning strategies as those that require students to do something with content, such as solving problems, discussing cases or applying concepts, rather than only listening, and they note that such strategies promote deeper learning and the transfer of knowledge to practice. A flipped classroom is one structured way to make room for those strategies.

The evidence for flipped classrooms in nursing is encouraging, though not without limits. Barranquero-Herbosa et al. (2022) gathered 15 reviews, nine integrative and six systematic, that together covered 274 studies and 34,608 nursing students. When flipped and traditional teaching were compared, the flipped format came out ahead on performance, competencies and satisfaction across a large number of comparisons. The authors also found high heterogeneity and medium to low methodological quality, and they called for stronger studies. The honest conclusion is that flipping is likely to help, especially for application, but educators should evaluate it in their own courses rather than assume it works.

Here is how a 90-minute anticoagulant class would change. Before class, students watch two eight-minute videos on mechanisms and monitoring and read a one-page summary. Class opens with a ten-question readiness quiz, followed by a five-minute clarification of any concept most students missed. The next 60 minutes are spent on three cases in small groups: a patient on warfarin with an INR of 3.8 scheduled for a dose, a postoperative patient on heparin whose platelets have fallen from 240,000 to 110,000, and an older adult on apixaban who has fallen and hit their head. Each group decides what to do and explains why, and the instructor circulates, asks questions and corrects errors. The final 15 minutes pull together the key decisions and preview the next unit. Compared with the current lecture, students would hear less explanation from me in class but would make at least three anticoagulant decisions themselves, explain their reasoning aloud, and receive immediate correction. To find out whether the change helps, I would compare students' scores on the anticoagulant items of the unit exam with the previous cohort's and ask clinical instructors whether students seem more confident with these decisions in the following weeks.

Paul told the Philippians, "What you have learned and received and heard and seen in me, practice these things" (English Standard Version Bible, 2001/2016, Philippians 4:9). Learning, in that verse, is completed by practice, which is exactly what a lecture-only class leaves out: students who have only heard can easily believe they are ready when they have never tried.

Reply to Courtney

Courtney, your concern that weaker students will skip the pre-class work and fall further behind in a flipped class is the objection I hear most often from faculty, and I think it deserves a real answer. One response is the readiness quiz at the start of class, which gives students a low-stakes reason to prepare and gives the instructor immediate information about who did not. Another is to make sure the in-class activities themselves teach reasoning, so that even an underprepared student learns something by working beside peers. Neethling and Roets (2025) reviewed 18 articles on strategies for developing clinical reasoning in nursing students and found that classroom activities were the most frequently reported approach, alongside simulation and e-learning, and that all of the strategies they identified enhanced clinical reasoning. That suggests the case work at the center of a flipped class is valuable in its own right. Proverbs 13:20 observes that "whoever walks with the wise becomes wise" (English Standard Version Bible, 2001/2016), which I take as encouragement to let students reason alongside one another rather than alone. Have you considered pairing students who struggled on the readiness quiz with stronger peers for the case work, so the group itself becomes a support? I would be interested to know whether your students would see that as helpful or as embarrassing. In my preceptor's course, students seemed to accept mixed groups when the instructor assigned them openly at the start of the term rather than after a poor quiz score, which avoided singling anyone out.

Reply to Gabriel

Gabriel, your idea of using an AI chatbot during in-class case work, so students can check their reasoning while the instructor circulates, is creative, and I think recent research gives you both encouragement and a caution. In a randomized trial (Meşe et al., 2026), researchers assigned nursing students to work on surgical case nursing diagnoses alone, alone with ChatGPT, or with a peer and ChatGPT over three weeks. Diagnostic skills improved in all groups, but neither ChatGPT condition produced a significant advantage over working without it, and the peer plus ChatGPT group showed a nonsignificant rise in the kind of cognitive effort associated with learning. That suggests the tool adds less on its own than we might hope, and that pairing it with peer discussion may matter more than the tool itself. For your class, it might be best to ask students to discuss their reasoning with a partner first and then use the chatbot to test it, so the thinking stays with the students. Proverbs 2:6 reminds us that "the Lord gives wisdom; from his mouth come knowledge and understanding" (English Standard Version Bible, 2001/2016), and I think it also reminds educators that tools can support but not replace the slow work of understanding. How would you evaluate whether the chatbot is helping your students reason, rather than simply giving them answers they copy? One option might be to collect each pair's reasoning before they consult the tool and compare it with their final answer, which would show whether the chatbot changed their thinking or only their wording.

References

Barranquero-Herbosa, M., Abajas-Bustillo, R., & Ortego-Maté, C. (2022). Effectiveness of flipped classroom in nursing education: A systematic review of systematic and integrative reviews. International Journal of Nursing Studies, 135, Article 104327. https://doi.org/10.1016/j.ijnurstu.2022.104327

Billings, D. M., & Halstead, J. A. (2016). Teaching in nursing: A guide for faculty (5th ed.). Elsevier.

English Standard Version Bible. (2016). Crossway. (Original work published 2001)

Meşe, S., Pan, Y., Meşe, C., & Sirganci, G. (2026). Comparing individual and peer-supported ChatGPT use in nursing case analysis: Effects on nursing diagnostic skills and cognitive load in a randomized controlled trial. Nurse Education in Practice, 96, Article 104949. https://doi.org/10.1016/j.nepr.2026.104949

Neethling, A., & Roets, L. (2025). Strategies to develop clinical reasoning in nursing students: A structured review. Health SA Gesondheid, 30, Article 2889. https://doi.org/10.4102/hsag.v30i0.2889