Long-term effects of flipped learning on nurses' self-efficacy and satisfaction in pressure injury management: A...

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.

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.

A single-blind, multicenter, quasi-experimental, two-group parallel repeated-measures design was conducted in seven medical institutions.

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.

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.

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.