The effects of online and offline problem-based learning (PBL) in Obstetrics Nursing Course in China:achieving the advantage of integration and distinguishing the relationship between student participation and teaching evaluation

Background: Problem-based learning (PBL) has been endorsed nursing education. Objective: This study aimed to assess students' satisfaction and the learning outcomes of the combined online and offline problem-based learning (PBL) method. Design: Third-year undergraduate nursing students(n=238) from two classes participated,each class were randomly divided into 8 groups(14 to 15 students/one group). 8 teachers participated, each conducting 2 offline PBL sessions. Methods: Hypertensive disorders of pregnancy were selected as teaching cases. Teachers uploaded teaching resources on the teaching platform for a one-week period of online self-directed learning. Each group addressed two questions in the offline class through presentations, scenario simulation, and role-playing activities. Students were asked to fill out the Satisfaction Questionnaire anonymously after class. Results: 80.27% of students were more satisfied with this approach compared to traditional methods, 92.83% felt that the learning outcomes met or exceeded expectations. Students who carefully collected, analyzed, and organized data during online learning time, or who spent ≥ 5 hours engaged in online learning, were more likely to meet or exceed their learning expectations (p < 0.05). The influence of participation activity on the learning effect was not significant (p > 0.05), but it did affect students' teaching evaluations (p < 0.05). There were significant differences in the session evaluation of the two classes (p < 0.05). Conclusion: This method was associated with higher student satisfaction in the Obstetrics and Gynecology Nursing course. The length of learning online and the degree of preparation significantly affect the learning effect. Students' participation did not reflect the learning effect but may involve teaching evaluation.