Students' motivation, study-effort and perceptions of teachers' goals when engaging in a learning design within the flipped classroom.

Background: A bachelor's degree in nursing at a large university in Norway has designed and developed a specific learning design within a flipped classroom to engage and motivate nursing students in their learning of cardiopulmonary resuscitation (CPR), facilitating progression throughout the three academic years of the nursing program. This comprehensive learning design is perceived as a cohesive unit and consists of two pre-class activities and two in-class activities. The four learning activities are multiple choice questions (MCQ), skills training with Resuscitation Quality Improvement (RQI), team-based learning (TBL) and simulation.

Aims: To investigate the associations between nursing students' autonomous motivation when performing four learning activities in a flipped classroom design and their perceptions of teachers' goals, study-effort and perceived learning outcomes.

Methods: Quantitative data were tested by means of stepwise regression analysis. Using a cross-sectional design, data were collected from 374 nursing students. Three hypotheses of the associations between nursing students' autonomous motivation when performing four learning activities in the flipped classroom learning design and their perceptions of teachers' goals, study-effort and perceived learning outcomes.

Results: There are significant associations between students' perceptions of teachers' goals and study-effort and their perceived learning outcomes when they perform the four learning activities. The correlations between students' autonomous motivation to perform the four learning activities and their perceived learning outcomes in CPR are positive and significant. The regression model explained 32% of the variance in perceived learning outcomes, with students' perceptions of teachers' goals and study-effort showing the strongest associations (β = 27 and β = 21, respectively).

Conclusion: This study provides empirical knowledge of the impact of students' autonomous motivation when performing four learning activities and their perceived learning outcomes. Based on the results of this study, the use of a learning design containing pre-class and in-class activities seems to support nursing students' learning processes.