<b>Undergraduate Nursing Students’ Satisfaction with Blended Learning Using the Flipped Classroom Approach in the Infection Prevention and Control Course</b>

Background: Nursing education increasingly requires pedagogical strategies that actively engage students and prepare them for clinical decision-making. The flipped classroom, particularly when integrated into blended learning, has been shown to enhance autonomy, collaboration, and knowledge application. However, evidence on student satisfaction in low- and middle-income countries, including Pakistan, remains limited. Objective: To evaluate undergraduate nursing students’ satisfaction with a flipped classroom approach integrated into blended learning for the Infection Prevention and Control course. Methods: A descriptive cross-sectional study was conducted among 150 first-semester Bachelor of Science in Nursing students from four institutes in Karachi, Pakistan. Participants completed a validated 30-item Blended Learning Satisfaction Scale on a 5-point Likert scale. Reliability was confirmed (Cronbach’s α = 0.937). Data were analysed using SPSS version 26, with descriptive and inferential statistics, including t-tests, chi-square, and effect size estimation. Results: The overall mean satisfaction score was 4.2 (SD = 0.7), reflecting high satisfaction. Engagement (M = 4.3, SD = 1.0), self-directed learning (M = 4.3, SD = 1.0), and clarity of course requirements (M = 4.4, SD = 1.1) received the highest ratings. Lower scores were observed for mixed-gender participation (M = 3.6, SD = 1.4, p = 0.019) and synchronous interaction challenges (M = 3.8, SD = 1.4). No significant differences were found across institutional types. Conclusion: The flipped classroom within blended learning fosters engagement, collaboration, and applied learning in nursing education. Cultural and structural barriers, particularly gender-related constraints, require targeted adaptation for sustained integration.