HealthyNCT07391865
The Effect of Chronotype on Motivation and Academic Achievement in Nursing Students Trained With a Flipped Learning Approach
A study testing Flipped classroom approach in people with Healthy, run by Trakya University.
Trial summary
The rapidly evolving world has influenced the sleep-wake cycles of nursing students, shifting them towards an evening chronotype. This shift has negatively impacted their daytime functionality, motivation, and academic success. Read more about this study
- Who is it for?
- Any ageHealthy volunteers can take part
- Conditions the study is for
- Healthy
- What is being tested?
- Flipped classroom approach
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 111 participants
- Where
- No sites listed yet
- Study dates
- 6 Feb 2023to 6 May 2023
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Any age
- All sexes
- Healthy volunteers accepted
- Child, Adult, Older adult
Who may be able to join
- Be over 18 years of age,
- To volunteer,
- Taking the Fundamentals of Nursing course for the first time,
- To own a smartphone or computer,
- To have internet access.
Who cannot join
- Being under 18 years of age,
- Not being a volunteer,
- Having previously taken the Fundamentals of Nursing course,
- Not owning a smartphone or computer.
- Not having internet access.
About this study
Official title: The Effect of Chronotype on Motivation and Academic Achievement in Nursing Students Trained With Flipped Learning Approach: A Randomized Controlled Trial
The rapidly evolving world has influenced the sleep-wake cycles of nursing students, shifting them towards an evening chronotype. This shift has negatively impacted their daytime functionality, motivation, and academic success. Moreover, research indicates that there is an asynchrony between individuals' circadian rhythms and face-to-face classes. Flipped learning can be seen as a potential solution to nursing education. The purpose of this study was to examine the effect of chronotype on motivation and academic achievement in nursing students trained with two different learning approaches.
Read the detailed description
This study were conducted a randomized controlled experimental design incorporating pre-test and post-test follow-ups. The study sample consisted of volunteer nursing students at the nursing department of a university in western Turkey. In this department, an internship program is offered and the Fundamentals of Nursing course, which is designed to provide 5 hours of theoretical instruction and 8 hours of practical training during the spring semester. The theoretical parts of the courses are conducted in lecture halls using a traditional classroom approach, while the practical parts are carried out in laboratories and clinics. As part of the course, after the instructor delivers the theoretical lecture, students watch videos related to the topic in the lecture hall to enhance their psychomotor skills. The application steps are then explained, followed by hands-on practice in the laboratory.
G*Power 3.1 software was utilized for the power analysis of the study. Based on the study by Aksoy and Gurdoğan, with an effect size of 0.79, a power of 95%, and a significance level of 0.05, it was determined that a minimum of 43 students should be assigned to each group. However, considering a 20% loss rate during the study, it was decided to include at least 52 students in each group. The students were randomly divided into two groups, the experimental and control groups, using the simple randomization method with the Research Randomizer program. A total of 114 students who met the study criteria were assigned to the experimental and control groups, with 57 students in each group. However, three students in the experimental group were excluded from the study because they participated in the training but did not complete the post-training data collection forms. Thus, the study was completed with a total of 111 students, including 57 in the control group and 54 in the experimental group. Turkish version of Morningness-Eveningness Questionnaire and Motivated Strategies for Learning Questionnaire, and theory and skill exams specific to urinary system were used for data collection.
- Conditions
- Healthy
- Being tested
- Flipped classroom approach
- Keywords
- Nursing students, flipped classroom, traditional training, chronotype, academic performance, motivation
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Flipped classroom approachOther
Also called Education
The experimental group students were taught the topic titled "Urinary System Applications" based on the FCA. The link to the online education platform required for out-of-class learning in this approach was shared with the students two weeks before the start of the course. Thus, students were able to watch the videos anytime and anywhere at their convenience. The educational platform included 31 videos on urinary system practices, specially prepared by researchers based on Bloom's taxonomy. These videos were organized into 31 sequential and thematically cohesive parts, and each part was interconnected.
The student could not watch a subsequent part without completing the previous related part. Each video was 10-15 minutes long, with one video introducing the online platform, 27 videos covering the theoretical aspects of the subject, and 3 videos focusing on skill application. Specific questions tailored to the learning outcomes of the subject were embedded in each video. Access to the
| Study group | Role | What they receive |
|---|---|---|
| The Flipped classroom group | Experimental | The experimental group students were taught the topic titled "Urinary System Applications" based on the flipped classroom approach Receives: Other: Flipped classroom approach |
| The traditional classroom approach group | No intervention | The control group students were taught the topic titled "Urinary System Applications" based on the traditional classroom approach. |
What is being measured
The primary outcome is the main question the study is designed to answer.
The Motivated Strategies for Learning Questionnaire (MSLQ)
The questionnaire was developed by Pintrich et al. in 1991.24 It was adapted to Turkish language by by Büyüköztürk et al. in 2004. This scale allowing students to indicate how well the items describe their personal situation. This scale consists of two main section, learning strategies and motivation, and 15 sub-dimensions. Responses are provided on a 7-point Likert scale, ranging from "not at all true of me" to "very true of me". In this study, the motivation section with its 6 sub-dimensions were applied to the students. Each sub-dimension is scored separately, and increasing scores indicate increased student motivation.
Measured: Before courses begin and 15 days after the courses concluded, an average of 7 weeks
The Morningness-Eveningness Questionnaire (MEQ)
The self-assessment-based form was developed by Horne and Östberg in 1976. The Turkish validity and reliability study was conducted by Pündük et al. in 2005. The form, which is used to determine morningness and eveningness types in the human circadian rhythm, consists of 19 questions. The minimum score that can be obtained from the form is 16, while the maximum score is 86. Based on the total score, individuals are classified as evening type, intermediate type, and morning type. While the Cronbach's alpha value was reported as 0.81 in the study by Pündük et al., it was found to be 0.72 in this study.
Measured: Before courses begin and 15 days after the courses concluded, an average of 7 weeks
The theoretical exam
The theoretical exam was developed by the researchers based on the guidelines and standards outlined by the Centers for Disease Control and Prevention. A detailed rubric evaluation was utilized to score student responses. The exam included four open-ended questions. The exam content included questions about the steps of urinary catheterization, types of urinary incontinence and their nursing care, urinary tract infections associated with urinary catheters, and a case study.
Measured: 15 days after the courses concluded, an average of 7 weeks
The skill exam
The skill exam was conducted using a urinary catheterization skill checklist, which consisted of 40 steps and specified the score for each step, prepared based on the literatüre. Both the theoretical and skill exams were graded on a 0-100 scale and were conducted 15 days after the courses concluded. The evaluation were carried out by an independent faculty member who was blinded to the group assignments (experimental or control).
Measured: 15 days after the courses concluded, an average of 7 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted6 Feb 2026
- Study start6 Feb 2023
- Primary completion6 May 2023
- Study completion6 May 2023
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (6)Papers the sponsor has linked to this study.
- Other trials for HealthyStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 111 participants (actual)
Sponsor and investigators
- Lead sponsor
- Trakya University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Berna Aksoy Kahraman, Trakya University
- Investigators
- Eylem PASLI GÜRDOĞAN, PhD, Principal investigator, Trakya University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07391865
- Sponsor's protocol ID
- TÜTF-BAEK 2022/189
- Status last verified
- Mar 2026
- First submitted
- 2 Dec 2025
- Last updated
- 23 Mar 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Pintrich, P. R., Smith, D., García, T., McKeachie, W. 1991. A manual for the use of the Motivated Strategies for Learning Questionnaire (MSLQ). University of Michigan.
Nam, D., Demircioğlu Diren, D., Horzum, M. B. 2024. Online learning barriers and its relationship to gender, age, work status, and chronotype in university student. Biological Rhythm Research. 55: 260-277. doi: 10.1080/09291016.2024.2336926
Büyüköztürk, S., Akgün, Ö. E., Özkahveci, Ö., Demirel, F. 2004. The validity and reliability study of the Turkish version of the motivated strategies for learning questionnaire. Educational Sciences: Theory & Practice. 4: 231-239
Balci O, Caliskan M. Investigation of the relationship between chronotype, learning style and academic achievement of university students during distance education in the pandemic period. Chronobiol Int. 2022 Jun;39(6):858-871. doi: 10.1080/07420528.2022.2041658. Epub 2022 Feb 17.
PubMed 35176946Aguilar, R., Santana, M., Larrañeta, B., Cuevas, G. 2021. Flipping the strategic management classroom: Undergraduate students' learning outcomes. Scandinavian Journal of Educational Research. 65:1081-1096. doi:10.1080/00313831.2020.1825524
Adan A, Archer SN, Hidalgo MP, Di Milia L, Natale V, Randler C. Circadian typology: a comprehensive review. Chronobiol Int. 2012 Nov;29(9):1153-75. doi: 10.3109/07420528.2012.719971. Epub 2012 Sep 24.
PubMed 23004349
Study at a glance
From the registry record, last updated by the sponsor on 23 Mar 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Effect of Chronotype on Motivation and Academic Achievement in Nursing Students Trained With Flipped Learning Approach: A Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT07391865
- Acronym / sponsor ID
- TÜTF-BAEK 2022/189
- Conditions
- Healthy
- Keywords
- Nursing students, flipped classroom, traditional training, chronotype, academic performance, motivation
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 111 participants (actual)
- Lead sponsor
- Trakya UniversityUniversity, hospital or other
- Study start
- 6 Feb 2023 (actual)
- Primary completion
- 6 May 2023 (actual)
- Study completion
- 6 May 2023 (actual)
- First posted
- 6 Feb 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The rapidly evolving world has influenced the sleep-wake cycles of nursing students, shifting them towards an evening chronotype. This shift has negatively impacted their daytime functionality, motivation, and academic success. Moreover, research indicates that there is an asynchrony between individuals' circadian rhythms and face-to-face classes. Flipped learning can be seen as a potential solution to nursing education. The purpose of this study was to examine the effect of chronotype on motivation and academic achievement in nursing students trained with two different learning approaches.
Detailed description
This study were conducted a randomized controlled experimental design incorporating pre-test and post-test follow-ups. The study sample consisted of volunteer nursing students at the nursing department of a university in western Turkey. In this department, an internship program is offered and the Fundamentals of Nursing course, which is designed to provide 5 hours of theoretical instruction and 8 hours of practical training during the spring semester. The theoretical parts of the courses are conducted in lecture halls using a traditional classroom approach, while the practical parts are carried out in laboratories and clinics. As part of the course, after the instructor delivers the theoretical lecture, students watch videos related to the topic in the lecture hall to enhance their psychomotor skills. The application steps are then explained, followed by hands-on practice in the laboratory.
G*Power 3.1 software was utilized for the power analysis of the study. Based on the study by Aksoy and Gurdoğan, with an effect size of 0.79, a power of 95%, and a significance level of 0.05, it was determined that a minimum of 43 students should be assigned to each group. However, considering a 20% loss rate during the study, it was decided to include at least 52 students in each group. The students were randomly divided into two groups, the experimental and control groups, using the simple randomization method with the Research Randomizer program. A total of 114 students who met the study criteria were assigned to the experimental and control groups, with 57 students in each group. However, three students in the experimental group were excluded from the study because they participated in the training but did not complete the post-training data collection forms. Thus, the study was completed with a total of 111 students, including 57 in the control group and 54 in the experimental group. Turkish version of Morningness-Eveningness Questionnaire and Motivated Strategies for Learning Questionnaire, and theory and skill exams specific to urinary system were used for data collection.
Study design
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| The Flipped classroom group | Experimental | Other: Flipped classroom approachThe experimental group students were taught the topic titled "Urinary System Applications" based on the flipped classroom approach |
| The traditional classroom approach group | No intervention | –The control group students were taught the topic titled "Urinary System Applications" based on the traditional classroom approach. |
Who may qualify
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (5 listed)
- Be over 18 years of age,
- To volunteer,
- Taking the Fundamentals of Nursing course for the first time,
- To own a smartphone or computer,
- To have internet access.
Key exclusion criteria (5 listed)
- Being under 18 years of age,
- Not being a volunteer,
- Having previously taken the Fundamentals of Nursing course,
- Not owning a smartphone or computer.
- Not having internet access.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Flipped classroom approachAlso: EducationThe experimental group students were taught the topic titled "Urinary System Applications" based on the FCA. The link to the online education platform required for out-of-class learning in this approach was shared with the students two weeks before the start of the course. Thus, students were able to watch the videos anytime and anywhere at their convenience. The educational platform included 31 videos on urinary system practices, specially prepared by researchers based on Bloom's taxonomy. These videos were organized into 31 sequential and thematically cohesive parts, and each part was interconnected. The student could not watch a subsequent part without completing the previous related part. Each video was 10-15 minutes long, with one video introducing the online platform, 27 videos covering the theoretical aspects of the subject, and 3 videos focusing on skill application. Specific questions tailored to the learning outcomes of the subject were embedded in each video. Access to the | Other | The Flipped classroom group |
Primary outcome
The Motivated Strategies for Learning Questionnaire (MSLQ)
Time frame: Before courses begin and 15 days after the courses concluded, an average of 7 weeks
The questionnaire was developed by Pintrich et al. in 1991.24 It was adapted to Turkish language by by Büyüköztürk et al. in 2004. This scale allowing students to indicate how well the items describe their personal situation. This scale consists of two main section, learning strategies and motivation, and 15 sub-dimensions. Responses are provided on a 7-point Likert scale, ranging from "not at all true of me" to "very true of me". In this study, the motivation section with its 6 sub-dimensions were applied to the students. Each sub-dimension is scored separately, and increasing scores indicate increased student motivation.
The Morningness-Eveningness Questionnaire (MEQ)
Time frame: Before courses begin and 15 days after the courses concluded, an average of 7 weeks
The self-assessment-based form was developed by Horne and Östberg in 1976. The Turkish validity and reliability study was conducted by Pündük et al. in 2005. The form, which is used to determine morningness and eveningness types in the human circadian rhythm, consists of 19 questions. The minimum score that can be obtained from the form is 16, while the maximum score is 86. Based on the total score, individuals are classified as evening type, intermediate type, and morning type. While the Cronbach's alpha value was reported as 0.81 in the study by Pündük et al., it was found to be 0.72 in this study.
The theoretical exam
Time frame: 15 days after the courses concluded, an average of 7 weeks
The theoretical exam was developed by the researchers based on the guidelines and standards outlined by the Centers for Disease Control and Prevention. A detailed rubric evaluation was utilized to score student responses. The exam included four open-ended questions. The exam content included questions about the steps of urinary catheterization, types of urinary incontinence and their nursing care, urinary tract infections associated with urinary catheters, and a case study.
The skill exam
Time frame: 15 days after the courses concluded, an average of 7 weeks
The skill exam was conducted using a urinary catheterization skill checklist, which consisted of 40 steps and specified the score for each step, prepared based on the literatüre. Both the theoretical and skill exams were graded on a 0-100 scale and were conducted 15 days after the courses concluded. The evaluation were carried out by an independent faculty member who was blinded to the group assignments (experimental or control).
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 23 Mar 2026.
- Results publicationPintrich, P. R., Smith, D., García, T., McKeachie, W. 1991. A manual for the use of the Motivated Strategies for Learning Questionnaire (MSLQ). University of Michigan.
- Results publicationNam, D., Demircioğlu Diren, D., Horzum, M. B. 2024. Online learning barriers and its relationship to gender, age, work status, and chronotype in university student. Biological Rhythm Research. 55: 260-277. doi: 10.1080/09291016.2024.2336926
- Results publicationBüyüköztürk, S., Akgün, Ö. E., Özkahveci, Ö., Demirel, F. 2004. The validity and reliability study of the Turkish version of the motivated strategies for learning questionnaire. Educational Sciences: Theory & Practice. 4: 231-239
- Results publication: PubMed 35176946Balci O, Caliskan M. Investigation of the relationship between chronotype, learning style and academic achievement of university students during distance education in the pandemic period. Chronobiol Int. 2022 Jun;39(6):858-871. doi: 10.1080/07420528.2022.2041658. Epub 2022 Feb 17.
- Results publicationAguilar, R., Santana, M., Larrañeta, B., Cuevas, G. 2021. Flipping the strategic management classroom: Undergraduate students' learning outcomes. Scandinavian Journal of Educational Research. 65:1081-1096. doi:10.1080/00313831.2020.1825524
- Results publication: PubMed 23004349Adan A, Archer SN, Hidalgo MP, Di Milia L, Natale V, Randler C. Circadian typology: a comprehensive review. Chronobiol Int. 2012 Nov;29(9):1153-75. doi: 10.3109/07420528.2012.719971. Epub 2012 Sep 24.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Eylem PASLI GÜRDOĞAN, PhD principal investigator
Trakya University
Questions about this trial
What is this clinical trial studying?
A study testing Flipped classroom approach in people with Healthy, run by Trakya University.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 23 Mar 2026. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
The Motivated Strategies for Learning Questionnaire (MSLQ) (time frame: Before courses begin and 15 days after the courses concluded, an average of 7 weeks). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07391865, which also lists 6 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 23 Mar 2026.