Effectiveness of flipped classroom on learning and satisfaction of nursing students in physiology laboratory education: a quasi-experimental study

Physiology is a foundational course in the medical sciences, including nursing. More active learning strategies, such as the flipped classroom, can enhance educational effectiveness and support practical medical applications. Therefore, this study aimed to investigate the effect of the flipped classroom on learning in the physiology lab course. This quasi-experimental study compared lecture-based learning with a flipped classroom approach, using convenience sampling and randomized block allocation. The study population included all first-semester nursing students at Shahid Beheshti University of Medical Sciences during the academic year 2024–2025. Both groups received eight two-hour lecture sessions for the theoretical component of the course. The control group’s practical course consisted of lectures followed by hands-on practice, whereas the intervention group’s practical course employed a flipped classroom model, where students reviewed instructional videos before engaging in exercises and discussions during eight two-hour in-person sessions. One week after completing the training for theoretical and practical courses, satisfaction and learning were evaluated and compared in both groups. The study included 87 students (51 females (58.62%), 36 males (41.38%); mean age = 19.80 years, SD = 1.31). Chi-square tests revealed no significant gender differences between groups (χ2 (1, N = 87) = 0.25, p = 0.62). Similarly, an independent samples t-test showed no significant age differences between groups (t (85) = 0.88, p = 0.38). Independent samples t-tests revealed no significant differences between intervention and control groups in theoretical exam scores, both before (t (85) = 0.30, p = 0.77) and after (t (85) = 0.32, p = 0.75) the theoretical course. However, significant differences emerged after the practical course, with the intervention group scoring higher on both the practical course mark, with large effect sizes (t (85) = 5.61, p < 0.001, d = 1.21, η² = 0.27), and satisfaction scores, with large effect sizes (t (85) = 4.61, p < 0.001, d = 0.88, η² = 0.16). Paired t-tests showed significant improvements in nursing students’ knowledge scores after the theoretical course (t (86) = -54.72, p < 0.001), with a considerable effect size, dppc2 = 7.90, η² = 0.97. In addition, satisfaction scores after the practical course (t (86) = 8.42, p < 0.001) demonstrated a large effect size, dppc2 = 1.17, η² = 0.45. The flipped classroom (FC) significantly improved nursing students’ practical physiology learning and satisfaction compared to traditional lectures. While theoretical knowledge gains were similar, FC enhanced practical skills, engagement, and motivation. By combining pre-class preparation with interactive in-class activities, FC supports active, student-centered learning and better prepares students for clinical practice. These findings highlight FC as an effective strategy for enhancing educational outcomes in laboratory-based nursing courses. This study was registered on the Iranian registry of clinical trial (http://irct.behdasht.gov.ir) on 23.3.2025 with IRCT ID: IRCT20210131050189N13.