N582 Module 2 assignment: cognitive domain lesson plan using a flipped classroom, a full sample

From Numbers to Decisions: A Flipped-Classroom Lesson Plan for Teaching Arterial Blood Gas Interpretation

Student Name

Master of Science in Nursing Program, Aspen University

N582: Teaching Strategies in Nursing Education

Instructor Name

Month Day, Year

From Numbers to Decisions: A Flipped-Classroom Lesson Plan for Teaching Arterial Blood Gas Interpretation

Arterial blood gas interpretation is a classic example of cognitive domain content that students memorize but do not use. Second-year baccalaureate students in a composite medical-surgical course can recite normal values for pH, carbon dioxide and bicarbonate, yet on the unit they rarely connect an abnormal result to the patient in front of them or to a nursing action. In a traditional lecture, class time is spent presenting the rules, and students practice applying them alone, if at all.

This paper presents a lesson plan that flips that arrangement: students learn the rules before class through a short video and quiz, and class time is spent applying them to unfolding patient cases with the instructor present. The paper states the learning objectives, describes each part of the lesson, explains the evidence behind the design and sets out how learning will be assessed.

Learning Objectives

Objectives are written using the revised taxonomy of the cognitive domain, which arranges cognitive processes in six levels, beginning with remembering and understanding, moving through applying and analyzing, and ending with evaluating and creating (Anderson & Krathwohl, 2001). The pre-class work addresses the lower levels, and class time targets the higher ones. By the end of the lesson, students will be able to identify normal ranges for pH, partial pressure of carbon dioxide, bicarbonate and oxygen (remember); interpret a blood gas as acidosis or alkalosis, respiratory or metabolic, and compensated or uncompensated (apply); analyze a patient's history, assessment and blood gas together to identify the most likely cause (analyze); and select and justify a priority nursing action (evaluate).

The Lesson Plan

The table summarizes the sequence for a 100-minute class session and the work that precedes it.

The pre-class video teaches one consistent method: check the pH, determine whether the carbon dioxide or bicarbonate explains it, then assess compensation and oxygenation. Keeping the video short matters, since longer videos are often watched incompletely. The online quiz gives students immediate feedback and shows the instructor, before class, which ideas are weak.

The unfolding cases are the heart of the session. In the COPD case, for example, teams first interpret a chronic compensated respiratory acidosis, then receive a second blood gas after the patient is given high-flow oxygen and becomes drowsy, and must recognize worsening carbon dioxide retention and decide what to do. Each case ends with a question about the nurse's priority action, such as notifying the provider, adjusting oxygen within orders or preparing for noninvasive ventilation. Circulating among teams, the instructor asks questions rather than giving answers.

The Evidence Behind the Design

The flipped approach has good support in health professions education. In a meta-analysis of 28 comparative studies, Hew and Lo (2018) found a significant overall effect in favor of flipped over traditional classrooms (standardized mean difference 0.33), with no evidence of publication bias. Importantly for this lesson, the approach was more effective when instructors used quizzes at the start of each in-class session, and more students preferred the flipped format. The readiness check in this lesson is included for that reason: it holds students accountable for the pre-class work, activates what they learned and gives the instructor information for the brief review.

The design also answers a common concern about flipped classrooms, that students will not prepare. The online quiz, the start-of-class check and team work in which unprepared students are visible all create gentle accountability. For students who could not complete the pre-class work, for instance because of shift work, the video remains available and the first case can be structured so that team members model the method.

Assessment of Learning

Assessment is aligned with each objective. The pre-class and readiness quizzes measure remembering and basic application. The exit ticket presents a new case, a patient with sepsis and a metabolic acidosis with partial respiratory compensation, and asks students to interpret the blood gas, identify the likely cause and state and justify one priority nursing action, scored with a simple four-point rubric. The unit examination includes application-level items built on patient scenarios rather than isolated values. Results from the exit tickets guide the next class: if many students miss compensation, the instructor opens the next session with a brief case on it.

The instructor also evaluates the lesson itself. A two-question survey at the end of class asks students what helped most and what remained confusing, and the instructor compares exit ticket results with those from the previous year's lecture-based class on the same content, using the same case. If the flipped lesson does not improve application-level performance, the instructor examines whether students completed the pre-class work, whether the cases were at the right level of difficulty and whether team discussions stayed focused. Treating the lesson as a small experiment in this way is how a single teacher contributes to the evidence base for teaching.

Adapting for Diverse Learners and Settings

The design can be adapted, and planning for varied learners is part of the nurse educator's competency in facilitating learner development (Halstead, 2019). Captions and a transcript make the video accessible to students with hearing impairment and to those studying in a second language. The same structure works online, with synchronous breakout rooms for team cases, or in a clinical post-conference, where a real patient's blood gas replaces one of the cases. For accelerated or experienced students, the pre-class work can be shortened and a fourth, more complex mixed-disorder case added.

Conclusion

Arterial blood gas interpretation is a cognitive skill that students learn best by applying it to patients. A flipped lesson moves the transmission of rules outside class and devotes class time to unfolding cases, team discussion and decisions, with objectives and assessments aligned at the higher levels of the cognitive domain. The evidence supports the approach, particularly when class begins with a readiness quiz. For students who can recite normal values but freeze at the bedside, this design offers practice in the thinking the unit will require.

References

Anderson, L. W., & Krathwohl, D. R. (Eds.). (2001). A taxonomy for learning, teaching, and assessing: A revision of Bloom's taxonomy of educational objectives. Longman.

Halstead, J. A. (Ed.). (2019). NLN core competencies for nurse educators: A decade of influence. Wolters Kluwer.

Hew, K. F., & Lo, C. K. (2018). Flipped classroom improves student learning in health professions education: A meta-analysis. BMC Medical Education, 18, Article 38. https://doi.org/10.1186/s12909-018-1144-z