NURS 767 Week 3 Written Assignment 3 Example

Planning a Flipped Class on Postpartum Hemorrhage for Junior BSN Students: Objectives, Pre-Class Work, In-Class Cases and Checks for Learning

Where the Class Falls

The class comes in Week 4 of the maternal-newborn course, one week after students watched a worked-example video and took part in a 15-minute postpartum hemorrhage simulation with debriefing. They have now seen a hemorrhage, however briefly, and have questions: why the fundus mattered, why the instructor kept asking about the pad count, why the medication was given when it was. The class is designed to answer those questions and to build the concepts that the second simulation and the clinical days will test. Oermann et al. (2018) describe the teacher's task in a class like this as moving students from information to understanding, which requires them to work with the content rather than listen to it.

Objectives

When the 90 minutes are over, each student should be able to:

• 1. Explain how each of the four classic causes (poor uterine tone, genital tract trauma, retained tissue and clotting problems) causes postpartum bleeding and name one assessment finding for each.
• 2. Calculate cumulative quantitative blood loss from weighed pads and linens and compare it with the definition of postpartum hemorrhage.
• 3. Prioritize the nurse's actions in the first ten minutes of a hemorrhage caused by uterine atony.
• 4. Communicate a deteriorating postpartum patient's status using SBAR.

The definition used in objective 2 follows the American College of Obstetricians and Gynecologists (2017), which defines postpartum hemorrhage as cumulative blood loss of 1,000 mL or more, or blood loss accompanied by signs or symptoms of hypovolemia, within 24 hours after birth. Students often learn older definitions based on the type of birth, so the class will make the current definition explicit.

Why a Flipped Design

The objectives call for application, calculation and prioritization, which are best practiced with an instructor present, not memorized from a lecture. A flipped design moves the basic content outside class and uses the 90 minutes for practice. Evidence supports the approach, with qualifications. Yousefi et al. (2026) randomized 58 nursing students in a fluids and electrolytes course to a flipped classroom or lectures and found a large effect of the flipped classroom on post-test knowledge, along with higher student ratings of satisfaction, involvement, task orientation and innovation; the authors note the small sample, short duration and lack of long-term follow-up. Sarmadi et al. (2026) pooled studies comparing flipped classrooms and problem-based learning with conventional teaching on patient safety outcomes and found that flipped classrooms improved knowledge and skill but not attitudes, at low to very low certainty because the studies varied so much. The honest reading is that flipping is promising, not proven, and that its effect depends on whether students actually prepare.

Students' experience matters too. Pérez-Muñoz et al. (2026) interviewed 20 nursing students who had learned evidence-based practice in a flipped classroom; they described their initial fear giving way to a new sense of the material's meaning for their professional role, and they valued the cognitive work the approach demanded of them. That account fits what I want from this class: students who stop seeing hemorrhage as a frightening event and start seeing it as a set of cues they can act on.

Pre-Class Work

Pre-class work is limited to what students can finish in about thirty minutes, because a long assignment is the most common reason flipped classes fail. Students rewatch the eight-minute worked-example video, now with pauses that ask a question at each decision point, and read a one-page reference card on the four Ts and the first actions. They then take a five-question readiness quiz in the learning management system, due two hours before class. The quiz results tell me which ideas to address at the start of class and which students may need help keeping up.

In-Class Cases

The class centers on three cases of increasing difficulty, worked in groups of four, with a short whole-class discussion after each.

Case 1 (tone): a woman who gave birth vaginally two hours ago after a long induced labor has a boggy fundus displaced to the right and steady bleeding. Groups identify the likely cause, the reason the fundus is displaced and the first three actions. This case rehearses the simulation and builds confidence.

Case 2 (measurement): the same patient's weighed pads and underpads are given in grams, with the dry weights listed. Groups calculate cumulative blood loss, decide whether it meets the definition and identify which vital signs would confirm hypovolemia. Many students assume that visual estimates are good enough, so the case includes a nurse's visual estimate that is far lower than the weighed total, which opens a discussion of why quantitative measurement is the standard.

Case 3 (complexity): a woman two days after a cesarean birth reports dizziness and has a heart rate of 118, with modest visible bleeding and a firm fundus. Groups must consider causes other than tone, such as trauma or a coagulation problem, decide what to report and write an SBAR call to the provider. This case moves students beyond the rule they learned first, which Benner (1984) would describe as the start of seeing a situation as a whole.

Class Outline

Checking for Learning

Learning is checked three times. The readiness quiz shows what students bring. During the cases, I will move among the groups and listen for the reasoning behind answers, asking each group at least one question that requires an explanation rather than a fact. The exit ticket asks two questions: calculate a blood loss from given weights, and name the first action for a boggy fundus with heavy bleeding. Answers will be reviewed that evening, and any widespread error will be addressed at the start of the second simulation.

Students Who Arrive Unprepared

Some students will not do the pre-class work. Rather than excluding them, the plan mixes each group so that at least two members completed the quiz, and the first ten minutes of class review the two ideas the quiz showed were weakest. Students who missed the quiz will be asked to complete it after class. If more than a third of the class skips the preparation, the design is the problem, and the pre-class load will be reduced for the next flipped class.

Accessibility and Different Learners

A flipped design can disadvantage some students. Students who work long hours outside school may not have time for pre-class work, students with limited internet access at home may struggle with video and students who learn better by listening than by reading may find the reference card hard to use. The video will therefore be captioned and downloadable, the reference card will also be posted as an audio summary and the readiness quiz will stay open until two hours before class rather than closing the night before. Students with documented accommodations will receive the pre-class materials three days early. Group work raises its own problems: quieter students, including some for whom English is a second language, can be overlooked when confident peers dominate. Each group will rotate roles across the three cases, so that every student reads the case aloud, records the group's reasoning or reports to the class at least once. These adjustments cost little and make it more likely that the class works for everyone it is meant to teach.

Observation

A faculty member outside the course will observe the class using the school's peer observation form, as my practicum objectives require. I have asked the observer to watch two things in particular: whether I talk more than the students during the cases, and whether the timing holds. A flipped class succeeds when the teacher spends the hour listening to students reason rather than explaining what they could have read.

References

American College of Obstetricians and Gynecologists. (2017). Practice bulletin no. 183: Postpartum hemorrhage. Obstetrics & Gynecology, 130(4), e168-e186. https://doi.org/10.1097/AOG.0000000000002351

Benner, P. (1984). From novice to expert: Excellence and power in clinical nursing practice. Addison-Wesley.

Oermann, M. H., De Gagne, J. C., & Phillips, B. C. (Eds.). (2018). Teaching in nursing and role of the educator: The complete guide to best practice in teaching, evaluation, and curriculum development (2nd ed.). Springer Publishing Company.

Pérez-Muñoz, V., Ramos-Morcillo, A. J., Molina-Rodríguez, A., & Ruzafa-Martínez, M. (2026). Nursing students' experiences of learning evidence-based practice through a flipped classroom: A qualitative study. Nursing Reports, 16(5), 149. https://doi.org/10.3390/nursrep16050149

Sarmadi, S., Zare-Kaseb, A., & Sanaie, N. (2026). Effects of problem-based learning and flipped classroom educational methods on patient safety knowledge, attitudes and skills among nursing students: A systematic review and network meta-analysis. Nurse Education in Practice, 96, 104971. https://doi.org/10.1016/j.nepr.2026.104971

Yousefi, M. S., Fooladzadeh Dehghan, M., Ilkhani, M., Khajoei, R., Heidari, S., & Jokar, M. (2026). The effects of flipped classroom versus lecture-based learning on academic performance and perceptions of classroom environment among nursing students: A randomized controlled trial. BMC Medical Education, 26(1). https://doi.org/10.1186/s12909-026-09746-y