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Search strategies_
| #1 | “flipped classroom” OR “flipped teaching” OR “flipped classroom teaching method” OR “flipped model” OR “the flipped class model” OR “reverse classroom teaching” OR “reverse teaching” OR “contra-traditional teaching approach” OR flip*OR “active learning” OR “blended learning” OR “problem-based learning”[Title/Abstract] |
| #2 | “Education, Nursing”[Mesh] |
| #3 | nurs* OR students nurs* OR education nurs* OR “nurs* education research” OR nursing[Title/Abstract] |
| #4 | #2 OR #3 |
| #5 | “self-management” OR “desire for learning” OR “self-control” OR “self-regulated learning” OR “Independent learning capability” OR “autonomous learning ability” OR “Self-learning ability” OR “Self-direct learning” OR “Learner Autonomy” OR “self-learning readiness”[Title/ Abstract] |
| #6 | “randomized controlled trial” OR “random*” OR “RCT” |
| #7 | #1 AND #4 AND #5 AND #6 |
Characteristics of included studies_
| Author | Country | Design | Subject | Sample size | Curriculum | Intervention (duration) | Control | Measurement of outcomes |
|---|---|---|---|---|---|---|---|---|
| Wang38 | China | RCT | High vocational nursing students | E:50 C:51 | Medical nursing experiment teaching | FC: 1. Pre-class individual instruction 2. In-class group interactive activities (one semester) | Traditional teaching | SRL |
| Jing and Li34 | China | RCT | High vocational nursing students | E:50 C:52 | Assessment of technical symptoms of health assessment | OSCE and FC: 1. Pre-class individual instruction 2. In-class group interactive activities with OSCE (one semester) | Traditional teaching | ALC |
| Tian et al.37 | China | RCT | Nursing undergraduate intern | E:32 C:32 | Geriatric nursing | FC: 1. Pre-class individual instruction 2. In-class group interactive activities 3. After-class self-reflection and evaluation (one semester) | Traditional teaching | SRL |
| Chen et al.31 | China | RCT | Nursing undergraduate intern | E:36 C:36 | Emergency intensive care | BL and FC: 1. Pre-class individual instruction 2. In-class group interactive activities with OSCE (2 periods) | Traditional teaching | SRL |
| Song et al.36 | China | RCT | Nursing undergraduate intern | E:30 C:30 | Basic nursing, experimental teaching | FC: 1. Pre-class individual instruction 2. In-class group interactive activities; 3. After-class self-reflection and evaluation (4 periods) | Traditional teaching | Specially designed |
| Deng32 | China | RCT | Nursing undergraduate intern | E:34 C:32 | Introduction of nursing science | FC: 1. Pre-class individual instruction 2. In-class group interactive activities 3. After-class self-reflection and evaluation (one semester) | Traditional teaching | ALC |
| Zong et al.39 | China | RCT | High vocational nursing students | E:101 C:100 | Basic nursing, experimental teaching | FC with Wechat: 1. Pre-class individual instruction 2. In-class group interactive activities 3. After-class self-reflection and evaluation (two semesters) | Traditional teaching | SRL |
| Gagnon et al.7 | Canada | RCT | Nursing undergraduates | E:56 C:56 | Nursing research | BL with internet-based tutorials: 1. Pre-class individual instruction 2. In-class group interactive activities 3. After-class self-reflection and evaluation (13 periods) | Traditional teaching | SDLRSNE |
| Tian9 | China | Quasi-experiment | Nursing undergraduates | E:193 C:129 | Basic nursing, experimental teaching | FC: 1. Pre-class individual instruction 2. In-class group interactive activities 3. After-class self-reflection and evaluation (one semester) | Traditional teaching | SRL |
| Liu et al.35 | China | Quasi- experiment | Nursing undergraduates | E:31 C:30 | Optional courses for rehabilitation nursing | FC: 1. Pre-class individual instruction 2. In-class group interactive activities 3. After-class self-reflection and evaluation (one semester) | Traditional teaching | SRL |
| Hui33 | China | Quasi- experiment | High vocational nursing students | E:107 C:107 | Psychiatric nursing | FC: 1. Pre-class individual instruction 2. In-class group interactive activities 3. After-class self-reflection and evaluation (one semester) | Traditional teaching | CALNS |
| Jahromi et al.8 | Iran | Quasi- experiment | Nursing undergraduates | E:39 C:38 | Mental health and psychiatric disorders | TBL: 1. Readiness lesson by teacher 2. Readiness assurance test 3. Application as a team (two semesters) | Web quest teaching | SDLRS |
Description of self-directed learning measured by other scales_
| Outcomes | Trials | Sample size (EG/CG) | Intervention effect size (CI) | P-value of effect |
|---|---|---|---|---|
| ALC | ||||
| Self-management ability | Deng32 | 66 (34/32) | 1.51 [0.96, 2.06] | <0.00001 |
| Self-learning ability | Deng32 | 66 (34/32) | 1.56 [1.00, 2.11] | <0.00001 |
| Information literacy | Deng32 | 66 (34/32) | 2.26 [1.63, 2.89] | <0.00001 |
| CALNS | ||||
| Self-management ability | Hui33 | 214 (107/107) | 1.23 [−0.28, 2.74] | 0.11 |
| Self-learning ability | Hui33 | 214 (107/107) | 2.19 [1.08, 3.30] | 0.0001 |
| Information literacy | Hui33 | 214 (107/107) | 3.33 [1.66, 5.00] | <0.0001 |
| SDLRS | ||||
| Self-control ability | Jahromi et al.8 | 77 (39/38) | −0.79 [−1.25, −0.33] | 0.0009 |
| Self-engagement ability | Jahromi et al.8 | 77 (39/38) | 0.01 [−0.43, 0.46] | 0.95 |
| Self-management ability | Jahromi et al.8 | 77 (39/38) | 0.11 [−0.34, 0.55] | 0.64 |