BACKGROUND Educators face the ongoing difficulty of managing finite class time and limited instructor-student interactions to balance discourse and active learning. Complicating this is the growing expectation to incorporate technology into nursing curriculum. This study explored the differences of the traditional classroom lecture (TL) with the flipped classroom (FC) format and the effects on higher-order thinking. METHODS A content analysis was performed on previous work. Concept maps were used to evaluate data from transcripts of undergraduate nursing students' case study discussions in either a TL or FC format. RESULTS FC groups had a more complex concept map morphology and identified more subcategories and links. They exhibited a greater number of higher-order thinking concepts compared with the TL groups. The emergence of discussion tangents across both the FC and the TL groups was unexpected. CONCLUSIONS The FC approach enhances student learning and aids in the development of higher-order thinking. [.