Effects of flipped team-based learning on nursing students’ perceptions of clinical decision-making in a health promotion and education course

• The Flipped Team-based Learning (FTBL) improved students’ perceptions of clinical decision-making. • High level of peer interaction and the transition from individual study to team discussions and whole class discussions promote peer learning and teamwork in the FTBL. • The FTBL encourages active learning, promotes peer learning and teamwork, and improves problem-solving which may contribute to the positive outcome of FTBL. Flipped team-based learning (FTBL) is a blended educational strategy designed to facilitate active learning inside and outside the classroom. To determine the effect of FTBL on nursing students’ clinical decision-making perceptions and to explore their learning experiences. An explanatory mixed methods design was employed to study 125 first-year associate degree nursing students participated in FTBL in a 14-week semester of a health promotion and education course during the COVID-19 pandemic. Pre-posttest of Clinical Decision-Making in Nursing Scale (CDMNS) and two semi-structured focus groups were conducted to explore their clinical decision-making perceptions and learning experiences. Total CDMNS and all subscales increased significantly after the FTBL course ( p < .001), with total CDMNS rising significantly from 113.24 to 138.49 ( p < .001). Three themes emerged from focus groups: encourage active learning, promote peer learning and teamwork, and improve problem-solving which may contribute to the positive outcome of FTBL. This finding suggested that FTBL may be an effective blended learning strategy for improving nursing students’ clinical decision-making perceptions and fostering learning experiences.