BMC Nursing · Published 2026-08-04 · DOI 10.1186/s12912-026-05022-y
Qin Xu, Norhasmah Mohd Zain, Nur Adibah Solihin Sulaiman, Hasni Embong
Abstract Background Clinical nursing education is essential for facilitating students’ successful transition into professional practice. The Rain Classroom-based Flipped Classroom (RC-BFC) model represents an innovative teaching strategy that emphasizes active, student-centered learning through the integration of technology-mediated interactions. By combining the interactive features of Rain Classroom—such as real-time feedback, quizzes, and cloud-based resources—with the core principles of the Flipped Classroom, the RC-BFC model fosters an engaging and supportive learning environment. This study aimed to implement and evaluate the RC-BFC model in surgical nursing skills training among Chinese nursing students from diverse academic backgrounds. It was hypothesized that this approach would more effectively enhance skill performance, self-directed learning abilities, and critical thinking compared to traditional methods. Methods A quasi-experimental design was employed to assess the effectiveness of the RC-BFC approach. The study involved 286 nursing interns from the Affiliated Hospital of Southwest Medical University in China, who were equally divided into an intervention group (receiving RC-BFC training) and a control group (undergoing traditional training). Pre- and post-intervention skill assessments were conducted, and two validated instruments were used to measure self-directed learning ability and critical thinking skills. Data were analyzed using SPSS version 26 through descriptive statistics, independent-samples t-tests, linear regression, and a three-way mixed-design ANOVA. Results There were statistically significant differences in skill performance between the two groups (p < 0.001). The mean scores of students instructed with the RC-BFC method (94.50 ± 4.34) in the final examination were significantly higher than those of the control group (85.70 ± 6.45). Moreover, students in the intervention group scored significantly higher in self-directed learning ability (234.07 ± 10.07 vs. 206.99 ± 9.09) and critical thinking ability (266.03 ± 17.86 vs. 235.74 ± 21.23) compared to those in the control group (p < 0.001). Conclusion Integrating the RC-BFC method into surgical nursing skills training can substantially enhance the skill proficiency, self-directed learning and critical thinking abilities of nursing students. Clinical trial number Not applicable.
Abstract from DOAJ. Public domain (CC0 1.0).
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Xu, Q., Zain, N., Sulaiman, N., et al. (2026). The Impact of Rain classroom-based flipped classroom (RC-BFC) on surgical nursing education enhancement. BMC Nursing. https://doi.org/10.1186/s12912-026-05022-y