الفهرس 
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Abstract
Clinical community nursing practices are important to provide nursing students with indirect experience of clinical situations, the students should have opportunities to apply learned content to situations they will encounter in practice. Nowadays, electronic based learning is used on campuses by students and could be considered a potential tool to deliver learning materials to nursing students. As a result of the vast technological advancements, FC has gained considerable popularity in higher education. In FC classroom, students get first exposure to new knowledge before class through various online platforms; hence, class could be carried out through strategies such as case-based, problem-based and team-based learning promoting knowledge applications. In addition, for teachers, class time is used to address students’ questions rather than merely make speeches (Phillips & Wiesbauer, 2022; Tamilselvan et al., 2023).
The aim of this present study was to evaluate the effect of electronic based learning application on practical skills among intervention group of community health nursing students. Therefore, this study was conducted to assess the difference between electronic based learning using flipped classroom method based on mobile application and traditional learning on practical skills of the studied students and attitude of them toward practical course using pre-determined learning methods, designing and implementing electronic based learning application on practical course and evaluating the degree of improvement of practical skills and attitudes among intervention group students after application of electronic based learning using flipped classroom method based on mobile application on practical course on practical course and evaluating electronic based learning using flipped classroom method based on mobile e-learning application on practical course.
Research design
Intervention study design was utilized to conduct this study.
The study was conducted at Clinical Lab of Community Health Nursing Department, Faculty of Nursing, in Benha University. The sample collected by using a systematic random sample of 25% was taken as one every fourth (63) of community health nursing undergraduates’ students, the participants were categorized into intervention and control groups (32 participants in control group and 31 in intervention group).
Tools: Four tools were used to collect the data: -
Tool (I): - A structured questionnaire format: It was developed by the researcher based on reviewing related literatures and it was written in simple clear English language: It comprised of two parts:- : - It was concerned with:
A-Personal characteristics of the studied students (intervention and control groups).
B-Data about electronics used by intervention group from community health nursing students.
Tool II:- Observational skills checklist that measured the nursing practical skills of the studied students (intervention and control groups), it was developed by the researcher based on a nursing textbook and clinical sheet on basic nursing skills adopted from (Nemeth, 2020; The Canadian Red Cross Comprehensive Guide for First Aid & CPR, 2022) through asking about practical skills steps regarding the five procedures (Cardio and Pulmonary Resuscitation (CPR); which comprised of twenty-nine steps, external bleeding; which comprised of fifteen steps and internal bleeding; it comprised of eleven steps, head injuries; which comprised of nine steps and spinal cord injuries; which comprised of eleven steps, seizure; which comprised of twelve steps and choking; which comprised of twenty- eight steps).
Tool II :- Attitude scale to measure the viewpoint of the studied students (intervention and control groups) toward practical course using pre-determined learning methods adapted from (Firmansyah et al., 2021). The questionnaire was measured by three a likert scale (agree, neutral and disagree) which was modified by researcher to assess the students’ confidence, usefulness, learning motivation and satisfaction of using learning methods.
Tool IV:- A structured questionnaire format that was developed to identify the intervention group from community health nursing students ’ evaluation for using flipped classroom based on mobile e-learning application on practical course adapted from (Darling-Hammond &Rorthman, 2011). The questionnaire was measured by three a likert scale (good, average and poor) which included three main items: Evaluation of practical course using flipped classroom based on mobile e-learning application, evaluation during implementation of mobile application and evaluation of flipped classroom based on mobile e-learning application:
The current study revealed the following results:-
- Regarding to personal characteristic of the studied students (intervention and control groups), 62.5 % of intervention group students aged from 21 to less than 22 years old with mean age was 21±0.86, beside, 50 % of the control group students aged from 21 to less than 22 years old with mean age was 22±0.95, not only, 90.6 % of intervention group students were females, but also 84.4 % of the control group students were females and furthermore, furthermore, 62.5 % of intervention group students lived in rural areas and 56.3% of the control group students lived in urban areas and then there are no statistically significant difference between the studied students (intervention and control group) regarding age, sex and place of residence.
- All of the intervention group from community health nursing students had advanced mobile phone and android OS of mobile phone, 56.3% of them had moderate internet speed, 84.4% of them are perfect users in practice of technology, 96.9% of them presented workshop about electronic learning and equally 87.5% of them use medical apps on the mobile for nursing care plan reference and drug reference.
-Regarding total practices level of the studied students (intervention and control groups) pre and post intervention; 38.7 % of the intervention group students had competent practice level pre intervention using flipped classroom method based on mobile e-learning application and then this percentage increased to 90.3% post-intervention, while 43.2 % of the control group students had competent practice level pre intervention using the traditional learning method and then increased to 68.7% post intervention.
- Regarding total attitude level of the studied students (intervention and control groups) pre and post intervention; 54.6 % of the intervention group students had positive attitude level pre intervention toward the flipped classroom method based mobile e-learning application and then this percentage increased to 90.3% post intervention, while 68.7% of the control group students had positive attitude level pre intervention toward the traditional learning method and then increased slightly to 71.9% post intervention.
- Regarding their evaluation of using flipped classroom method the mobile e-learning application; 83.9 % of the intervention group from community health nursing students evaluate of using flipped classroom method based on mobile e-learning application on practical course as good in the total and only 6.5 % of them evaluate using flipped classroom method based on mobile e-learning application on practical course as poor.
Based on the results of the present study and answering of research hypotheses, the following can be concluded:
Application of electronic based learning using flipped classroom method based on mobile learning application succeeded in improving the practical skills and attitudes of intervention group students compared by control group students using traditional learning method, also the study calculated that, there were positive highly statistically significant correlations between total practices and attitudes of the intervention group students toward electronic based learning using flipped classroom method based on mobile e-learning application on practical course.
Based on the study findings, it is recommended that:
1- Provision of adequate training programs to students on using flipped classroom method based on mobile e-learning application in education.
2- Implementation of new learning strategies to be used in both theoretical and clinical curriculums.
3- Further studies to evaluate the effect of using flipped classroom method based on mobile e-learning applications on nursing education for other subjects in different academic years.