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.

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.

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.

Inclusion Criteria

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

Exclusion Criteria

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)

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

Not applicable. Participants and researchers were aware of group assignments due to the nature of the educational intervention.