The Effect of Hybrid Team-Based Learning in a Professional Nursing Course

Sunday, 30 July 2017

Hui-Chen Tseng, PhD
Department of Nursing, Kaohsiung Medical University Chung-Ho Memorial HospitalTaiwan, Kaohsiung, Taiwan, Kaohsiung, Taiwan
Wei-Che Weng, MS
Department of Urology, Kaohsiung Municipal United Hospital, Taiwan, Kaohsiung, Taiwan
Lih-Mih Chen, PhD
College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan


We used the concept of flip-pedagogy to reform the traditional teaching model in Taiwan. The method of hybrid team-based learning (hybrid TBL) aims at the paradigm shifts of learning and teaching. The teaching behavior shifts from “sage on stage” to “guide at side”, and the responsibility for learning shifts from instructors to students. This study investigated the effectiveness of adopting hybrid TBL in a professional nursing course for Taiwanese baccalaureate nursing students.


A quasi-experimental design with experimental and control groups was used to evaluate the effectiveness of hybrid TBL method. A convenience sample of 71 Grade III nursing students participated in this study, with 40 in the experimental group and 31 in the control group. For the experimental group, 3 topics were selected for TBL out of overall 31 topics of a professional nursing course. The control group received the other professional nursing course with traditional method. We collected data from Self-Directed Learning Readiness scale and the Learning Outcome of TBL Self-evaluation before the professional course at the first time, and the second collection of data was collected after the intervention of TBL courses. The TBL method included IRT, GRT, application exercises and appeal. We examined the effect of students' learning outcomes from two scales: Self-Directed Learning Readiness scale and the Learning Outcome of TBL self-evaluation.


Our study showed that nursing student increased the hours of self-directed learning from11.2 hours to 14.3hours every week, and got the references of study from lectures of instructors (89.2%), textbook (64.6%), internet (64.6%) and book references (41.5%). The learning behaviors of team engagement and the overall effect of TBL self-evaluation had significant statistical differences between the experimental and control groups, but the learning behaviors of learning motivation, active learning and self-directed learning readiness rarely changed.


TBL is a teaching method of extrinsic motivation, thence the correlation between TBL and active learning behaviors is still a debate. This study provides the evidenced data of improvement in team engagement for adopting the hybrid team-based learning method in nursing courses. The proper frequency of team-based learning methods in a professional lecture nursing course still needs more evaluation to set on.