Comparing the Effect of Flipped Teaching versus Multimedia-based Teaching on Postoperative Physical Activity in Patients Undergoing Open-Heart Surgery

Background: Multimedia learning can be recommended for cardiopulmonary rehabilitation to reduce respiratory complications following open-heart surgery (OHS). Furthermore, flipped learning may reinforce the effects of education via further feedback. Aim: This study aimed to compare the effects of flipped teaching versus multimedia-based teaching on postoperative physical activity in patients undergoing OHS. Method: This controlled randomized clinical trial was conducted on a total of 60 patients admitted to an intensive care unit and a cardiac-surgical ward in northeastern Iran in 2019. In the multimedia learning group, a tutorial video was displayed three times a day at different stages, namely preoperation, 1-2 days after the surgery, and 2-3 days postsurgery. The flipped learning group was also subjected to the same tutorial with the potential to be displayed on smartphones. Then, the 6-Clicks instrument was completed to assess the basic mobility function. The data were analyzed in the IBM SPSS Statistics software (version 25) using the Mann-Whitney U and Friedman tests. Results: The groups were homogenous in terms of demographic characteristics. The mean duration of physical activity was not significantly different in the study groups at the preoperative stage (P=0.87), 2 days postoperation (P=0.09), and 5-6 days after surgery (P=0.10). Based on the inter-group comparison, the mean score of physical activity was significantly different between the groups receiving flipped (P<0.001) and multimedia (P<0.001) learning. Implications for Practice: The same as multimedia learning, flipped learning is able to improve physical activity in patients following OHS.