Undergraduate Nursing Students Endorse Education Standards in Blended e-Learning Theory Teaching during COVID-19 Pandemic
Authors: Tayyib Nahla , Alsolami Fatmah , Asfour Hayam , Alshhmemri Mohammed , Lindsay Grace , Ramaiah Pushpamala , Alsulami Sanaa , Ali Hala 
Published: December 2021

Aim:
The aim of this study was to survey student learning perspectives as measured by ‘student satisfaction’ following the rapid introduction of remote blended e-learning into the existing undergraduate nursing curriculum at Umm Al-Qura University, Saudi Arabia.

Background:
National legislation resulting from the spread of Covid-19 required all theoretical and practical nurse training to move immediately to online provision using an unfamiliar e-learning environment and associated tools.

Objective:
The objective of this study was to use a validated satisfaction questionnaire developed elsewhere, but within a similar educational context involving both theoretical and practical components, for the purpose of checking that educational objectives were being satisfactorily achieved across five relevant domains of educational enquiry, and to use survey findings to improve the online delivery of the nursing program in future academic years.

Methods:
A validated 35 item questionnaire was circulated online to all male and female nursing students in their 2nd, 3rd and 4th years of study. The questionnaire content was subdivided into the five domains of ‘Interaction’, ‘Instruction’, ‘Instructor’, ‘Course Management’ and ‘Technology’. Descriptive and comparative statistics were used to compare levels of satisfaction between genders and among undergraduate years of study, and against findings from undergraduate information technology undergraduates.

Results:
199 female and 84 male students completed the questionnaire (response rate 59.2%). Mean satisfaction scores for male and female nursing undergraduates were significantly greater than 3 (neutral score) in all domains of enquiry, indicating good satisfaction with blended e-learning (p<0.001). However, multivariate regressions of domain satisfaction scores taking gender and year of study as explanatory variables had poor resolving power. Domain scores were also significantly greater than those of a comparator study in three of the five domains (p<0.030) and similar in the domains of course management (p=0.717) and technology (p=0.677). Levels of satisfaction in males and females were similar in 80% of the survey questions, but in females, satisfaction was significantly lower in some questions concerning technology (p<0.003), willingness to interrupt the instructor (p=0.021), comparison of blended learning and face-to-face teaching (p=0.002) and timely feedback on tests and assignments (p=0.031). Fourth-year students showed the highest levels of satisfaction across all five domains.

Conclusion:
Undergraduate nursing students reported above-average satisfaction levels across all five domains of education provision. Despite an unfamiliar blended e-learning curriculum environment, they demonstrated compatible technological skills, satisfactory interaction with teachers and other students and engagement in the learning process. A number of recommendations identified in the literature as underlying a successful program of blended e-learning are recorded for the benefit of readers.