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. Based on the inter-group comparison, 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). However, the mean score of physical activity, on the second and fifth days until the sixth day at the postoperative stage, was significantly different in flipped (p 0.001) and multimedia (p 0.001) groups. Implications for Practice: Same as multimedia-based teaching, flipped teaching is able to improve physical activity in patients following OHS.