Effectiveness of flipped learning with blended teaching strategies on learning outcomes among first-year nursing students: A quasi-experimental study

Background Traditional lecture-based teaching methods in nursing education often fail to adequately prepare students for the complex clinical reasoning required in contemporary healthcare practice. This study evaluated the effectiveness of flipped learning integrated with blended teaching strategies on learning outcomes among first-year nursing students. Methods A quasi-experimental pre-post design was conducted with 40 first-year nursing students at a private university in Taiwan during the 2022 academic year. The intervention comprised five evidence-based components: digital learning platform implementation, multimedia educational resources, problem-based learning integration, gamification elements, and collaborative learning frameworks. Data were collected using validated instruments including the Self-Directed Learning Readiness Scale (SDLRS), Critical Thinking Disposition Inventory (CTDI), and Classroom Engagement Survey (CES). Paired t-tests analyzed pre-post intervention differences, with statistical significance set at p < 0.05. Results Significant improvements were observed in self-directed learning ability (3.66 ± 0.58 vs 3.90 ± 0.67, p = 0.005, Cohen's d = 0.47), classroom engagement (3.59 ± 0.54 vs 3.79 ± 0.57, p = 0.018, Cohen's d = 0.39), and academic performance (3.74 ± 0.69 vs 4.19 ± 0.67, p < 0.001, Cohen's d = 0.63). Learning motivation showed a statistically significant decrease (4.33 ± 0.44 vs 4.06 ± 0.63, p = 0.001, Cohen's d = −0.55), though qualitative findings revealed positive student perceptions, with 80% preferring blended learning methods over traditional approaches. Conclusions Flipped learning integrated with blended teaching strategies effectively enhanced self-directed learning capabilities, classroom engagement, and academic performance among first-year nursing students. The paradoxical motivation findings—quantitative decrease alongside qualitative enthusiasm—illuminate the multifaceted nature of student motivation during educational innovation and suggest that standardized motivation instruments may inadequately capture the nuanced experiences of learners adapting to novel pedagogical environments. These findings support the implementation of technology-enhanced pedagogical approaches in nursing education curricula.