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Pain ManagementFLIPNURSENCT07129044

The Effect of the Flipped Classroom Model on Pediatric Pain Management Knowledge and Learning Motivation of Nursing Students

A study testing Flipped Classroom Training on Pediatric Pain Management and Self-Directed Learning on Pediatric Pain Management in people with Pain Management, run by Mustafa Belli at 1 site in Turkey (Türkiye).

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The aim of this randomized controlled trial was to evaluate the effect of the flipped classroom model on pediatric pain management knowledge and learning motivation among nursing students. Read more about this study

Who is it for?
Any ageHealthy volunteers can take part
Conditions the study is for
Pain Management
What is being tested?
Flipped Classroom Training on Pediatric Pain Management and Self-Directed Learning on Pediatric Pain Management
Could I receive a placebo?
No, everyone receives an active treatment
How many people
84 participants
Where
1 siteTurkey (Türkiye)
Study dates
1 Feb 2022to 15 Aug 2022
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Any age
  • All sexes
  • Healthy volunteers accepted
  • Child, Adult, Older adult

Who may be able to join

  • Being enrolled in the "Child Health and Diseases Nursing" course for the first time
  • Having access to the Internet and a computer or smartphone
  • Agreeing to attend synchronous sessions via Google Classroom
  • Volunteering to participate in the study

Who cannot join

  • Having previously received any education on pediatric pain management
  • Withdrawing consent at any point during the study
  • Failing to complete the pre-test, post-test, or three-month follow-up assessment (e.g., missing a measurement session due to internet connectivity issues)

Trial locations and contacts

1 site in 1 country.

Turkey (Türkiye)1 site
  • Mehmet Akif Ersoy University, Faculty of Health Sciences

    Burdur, 15100

Other trials in Turkey (Türkiye)

About this study

Official title: The Effect of the Flipped Classroom Model on Nursing Students' Pediatric Pain Management Knowledge and Learning Motivation: A Randomized Controlled Trial

The aim of this randomized controlled trial was to evaluate the effect of the flipped classroom model on pediatric pain management knowledge and learning motivation among nursing students. A total of 84 third-year nursing students from a public university in Turkey were randomly assigned to intervention (n=42) and control (n=42) groups. The intervention group received education using the flipped classroom model, while the control group followed a self-directed learning approach.

Data were collected at three time points: before the intervention (pre-test), one month after the intervention (post-test), and three months after the intervention (follow-up test). The Pediatric Pain Knowledge Test and the Motivation Scale Towards Learning were used to assess outcomes.

Read more

At baseline, there were no significant differences between the groups. Post-test and follow-up results showed that the intervention group demonstrated a statistically significant and sustained increase in both pediatric pain knowledge and learning motivation scores (p<0.001), while the control group showed no meaningful change.

These findings support the flipped classroom model as an effective and sustainable teaching strategy in nursing education, particularly for improving knowledge and motivation in pediatric pain management.

Read the detailed description

This randomized controlled trial aimed to evaluate the effectiveness of the flipped classroom model in enhancing nursing students' pediatric pain management knowledge and learning motivation. The study was conducted at a public university in Turkey with 84 third-year undergraduate nursing students during the 2022-2023 academic year.

Participants were randomly assigned to either the intervention group (n = 42) or the control group (n = 42) using a computer-generated randomization list. The intervention group received the flipped classroom approach, which included:

Access to a specially designed online learning platform with educational videos and reading materials uploaded one week prior to the face-to-face sessions,

A face-to-face session focusing on discussion, case-based learning, and peer interaction led by the researcher,

Learning materials developed based on the "Pediatric Pain Management" content defined in the national nursing education curriculum and international guidelines.

The control group engaged in self-directed learning by studying the same written materials independently without structured guidance or interaction.

Data were collected at three time points:

Pre-test (baseline) before the intervention,

Post-test immediately after the intervention (1 month later),

Follow-up (retention test) three months after the intervention.

Two validated instruments were used:

Pediatric Nurses' Knowledge and Attitudes Survey Regarding Pain (PNKAS) adapted for nursing students to measure knowledge,

Motivation to Learn Scale to assess students' learning motivation.

A two-way mixed ANOVA was used to analyze the effects of the intervention across time and between groups. At baseline, no significant differences were found between groups in either knowledge or motivation scores. However, after the intervention, the intervention group showed statistically significant and sustained improvements in both variables, whereas the control group did not exhibit notable changes.

The findings support the use of the flipped classroom approach as an effective and sustainable educational strategy in nursing education, particularly in areas requiring complex knowledge and critical thinking such as pediatric pain management. Integration of this model into nursing curricula may enhance both cognitive outcomes and motivation to learn.

Conditions
Pain Management
Being tested
Flipped Classroom Training on Pediatric Pain Management, Self-Directed Learning on Pediatric Pain Management
Keywords
Pediatric pain management, Flipped classroom, Nursing students, Learning motivation, Randomized controlled trial
Medical subject headings
Agnosia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Flipped Classroom Training on Pediatric Pain ManagementBehavioural

    Participants in this group received pediatric pain management training designed to increase nursing students' knowledge and motivation. The training was delivered using a flipped classroom model over 4 weeks. Students were provided with pre-class educational materials, including video lectures, readings, and lecture notes. In-class sessions included interactive activities, discussions, case-based learning, and problem-solving exercises. Content was based on current pediatric pain management guidelines and adapted to nursing education standards.

  • Self-Directed Learning on Pediatric Pain ManagementBehavioural

    Participants in this group received pediatric pain management training designed to increase nursing students' knowledge and motivation. Students were provided with the same pre-class educational materials as the intervention group, including video lectures, readings, and lecture notes, for self-study without any interactive activities or instructor-led sessions. Content was based on current pediatric pain management guidelines and adapted to nursing education standards.

Study groups in NCT07129044
Study groupRoleWhat they receive
Flipped Classroom Training on Pediatric Pain ManagementExperimentalParticipants in this group received pediatric pain management training through a flipped classroom model for 4 weeks. Training videos and readings were provided in advance and in-class sessions included interactive activities, discussions, and case-based learning.
Receives: Behavioral: Flipped Classroom Training on Pediatric Pain Management
Self-Directed Learning on Pediatric Pain ManagementActive comparatorParticipants in this group received the same pediatric pain management materials as the intervention group (lecture notes, readings, and video lectures) for self-study without any interactive activities or instructor-led sessions.
Receives: Behavioral: Self-Directed Learning on Pediatric Pain Management

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Pediatric Pain Management Knowledge Score

    The Pediatric Pain Management Knowledge Scale, developed by Aydın \& Bektaş (2021), measures nursing students' knowledge of pediatric pain. It consists of 29 items rated on a 5-point Likert scale, covering six sub-dimensions: pain awareness (6 items), pain physiopathology (4), barriers to pain management (11), pain diagnosis (2), pain assessment (2), and pain control (4). Items 3, 6, 8, 10-15, 17, and 21 are reverse coded. Scores range from 29 to 145; higher scores indicate greater knowledge. In this study, Cronbach's alpha was 0.845.

    Measured: Baseline (pre-test), 1 month after intervention (post-test), and 3 months after intervention (follow-up)

Secondary outcomes (1)
  1. Motivation Level Toward Instructional Materials

    The Motivation Questionnaire for Instructional Materials (MMIM), developed by Keller (2006) and adapted into Turkish by Kutu \& Sözbilir (2011), measures students' motivation toward instructional materials. It has 24 items rated on a 5-point Likert scale, with two dimensions: attention-relevance (items 1-11) and confidence-satisfaction (items 12-24). Items 3, 12, 14, 16, and 18 are reverse coded. Scores range from 24 to 120; higher scores indicate higher motivation. Cronbach's alpha was 0.83 in the original study and 0.789 in this study.

    Measured: Baseline (pre-test), 1 month after intervention (post-test), and 3 months after intervention (follow-up)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted19 Aug 2025
  2. Study start1 Feb 2022
  3. Primary completion20 Jul 2022
  4. Study completion15 Aug 2022

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Other
Allocation
Randomised
Intervention model
Parallel groups
Model description
Participants were randomly assigned to either the intervention group receiving flipped classroom-based pediatric pain management training or the control group receiving self-directed learning. The intervention lasted four weeks, and data were collected at three time points: pre-test (baseline), post-test (immediately after the intervention), and follow-up (three months later).
Masking
None (open label)
Enrolment
84 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07129044
Sponsor's protocol ID
ErsoyU-Belli-FC2022
Other IDs
1070
Acronym
FLIPNURSE
Status last verified
Aug 2025
First submitted
4 Aug 2025
Last updated
19 Aug 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Individual participant data will not be shared because participants did not provide consent for external data sharing and the study materials are governed by institutional privacy regulations. Data will remain accessible only to the study team

Publications

  • Ekim A, Ocakci AF. Knowledge and attitudes regarding pain management of pediatric nurses in Turkey. Pain Manag Nurs. 2013 Dec;14(4):e262-e267. doi: 10.1016/j.pmn.2012.02.004. Epub 2012 Apr 4.

    PubMed 24315279
  • Martin F, Sun T, Westine CD. A systematic review of research on online teaching and learning from 2009 to 2018. Comput Educ. 2020 Dec;159:104009. doi: 10.1016/j.compedu.2020.104009. Epub 2020 Sep 9.

    PubMed 32921895
  • Paralikar S, Shah CJ, Joshi A, Kathrotia R. Acquisition of Higher-Order Cognitive Skills (HOCS) Using the Flipped Classroom Model: A Quasi-Experimental Study. Cureus. 2022 Apr 18;14(4):e24249. doi: 10.7759/cureus.24249. eCollection 2022 Apr.

    PubMed 35602838
  • Zhang D, Huang A, Lei Y, Liu H, Yang L, Wang C, Yuan T, Li X, Zhang L, Shang W. Nursing students' experiences and perceptions regarding in-class flipped classroom: a mixed-methods study. BMC Med Educ. 2025 May 8;25(1):675. doi: 10.1186/s12909-025-07248-x.

    PubMed 40340719
  • Yuan L. Effect of Educational Interventions for Improving the Nurses' Knowledge, Attitude, and Practice of Pediatric Pain Management: A Aystematic Review and Meta-Analysis. Pain Manag Nurs. 2024 Aug;25(4):e271-e278. doi: 10.1016/j.pmn.2024.04.005. Epub 2024 May 3.

    PubMed 38702258
  • Xu P, Chen Y, Nie W, Wang Y, Song T, Li H, Li J, Yi J, Zhao L. The effectiveness of a flipped classroom on the development of Chinese nursing students' skill competence: A systematic review and meta-analysis. Nurse Educ Today. 2019 Sep;80:67-77. doi: 10.1016/j.nedt.2019.06.005. Epub 2019 Jun 14.

    PubMed 31279251
  • Guidelines on the management of chronic pain in children. Geneva: World Health Organization; 2020. Available from http://www.ncbi.nlm.nih.gov/books/NBK566553/

    PubMed 33433967
  • Ulgen H, Tufekci FG. The Effect of Pain Management Education on Nurses' Pain Knowledge and Attitudes. Pain Manag Nurs. 2024 Jun;25(3):e186-e191. doi: 10.1016/j.pmn.2023.12.011. Epub 2024 Feb 10.

    PubMed 38342705
  • Ung A, Salamonson Y, Hu W, Gallego G. Assessing knowledge, perceptions and attitudes to pain management among medical and nursing students: a review of the literature. Br J Pain. 2016 Feb;10(1):8-21. doi: 10.1177/2049463715583142. Epub 2015 May 13.

    PubMed 27551407
  • Shi, X.-Y., Yin, Q., Wang, Q.-W., Lu, B.-R., Li, G.-X., Huang, S.-H., & Sun, Z.-G. (2025). Is the flipped classroom more effective than the traditional classroom in clinical medical education: A systematic review and meta-analysis. Frontiers in Education, 9, Article 1485540. https://doi.org/10.3389/feduc.2024.1485540

  • Shanmugam SR, Alabdullah AAS, Alenezi MH, Aldughyshim SK, Alnemer MF, Almutairi WK, Alhadyan GS, Albugomi RZ, Alkhulayfi FA. Knowledge and attitudes toward pediatric pain management among nursing interns from a selected university in Riyadh, Saudi Arabia: a descriptive cross-sectional quantitative study. PeerJ. 2025 Apr 21;13:e19288. doi: 10.7717/peerj.19288. eCollection 2025.

    PubMed 40276299
  • Atefeh S. Barriers and facilitators of pain management in children: a scoping review. BMC Anesthesiol. 2025 Apr 1;25(1):148. doi: 10.1186/s12871-025-02941-2.

    PubMed 40170135
  • Shah P, Siu A. Considerations for neonatal and pediatric pain management. Am J Health Syst Pharm. 2019 Sep 16;76(19):1511-1520. doi: 10.1093/ajhp/zxz166.

    PubMed 31504147
  • Raja SN, Carr DB, Cohen M, Finnerup NB, Flor H, Gibson S, Keefe FJ, Mogil JS, Ringkamp M, Sluka KA, Song XJ, Stevens B, Sullivan MD, Tutelman PR, Ushida T, Vader K. The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. Pain. 2020 Sep 1;161(9):1976-1982. doi: 10.1097/j.pain.0000000000001939.

    PubMed 32694387
  • Merrou S, Baslam A, Idrissi Jouicha A, Ouhaz Z, El Adib AR. Blended learning and simulation in nursing education: A quasi-experimental study on a nursing institute. J Educ Health Promot. 2023 Sep 29;12:303. doi: 10.4103/jehp.jehp_72_23. eCollection 2023.

    PubMed 38023106

Questions about this trial

What is this clinical trial studying?

A study testing Flipped Classroom Training on Pediatric Pain Management and Self-Directed Learning on Pediatric Pain Management in people with Pain Management, run by Mustafa Belli at 1 site in Turkey (Türkiye).

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 19 Aug 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Pediatric Pain Management Knowledge Score (time frame: Baseline (pre-test), 1 month after intervention (post-test), and 3 months after intervention (follow-up)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07129044, which also lists 34 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 Aug 2025.

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