Barriers and facilitators to online medical and nursing education during the COVID-19 pandemic: perspectives from international students from low- and middle-income countries and their teaching staff

Abstract

Background The COVID-19 pandemic posed a huge challenge to the education systems worldwide, forcing many countries to provisionally close educational institutions and deliver courses fully online. The aim of this study was to explore the quality of the online education in China for international medical and nursing students from low- and middle-income countries (LMICs) as well as the factors that influenced their satisfaction with online education during the COVID-19 pandemic. Methods Questionnaires were developed and administered to 316 international medical and nursing students and 120 teachers at a university in China. The Chi-square test was used to detect the influence of participants’ personal characteristics on their satisfaction with online education. The Kruskal–Wallis rank-sum test was employed to identify the negative and positive factors influencing the online education satisfaction. A binary logistic regression model was performed for multiple-factor analysis to determine the association of the different categories of influential factors—crisis-, learner-, instructor-, and course-related categories, with the online education satisfaction. Results Overall, 230 students (response rate 72.8%) and 95 teachers (response rate 79.2%) completed the survey. It was found that 36.5% of students and 61.1% of teachers were satisfied with the online education. Teachers’ professional title, students’ year of study, continent of origin and location of current residence significantly influenced the online education satisfaction. The most influential barrier for students was the severity of the COVID-19 situation and for teachers it was the sense of distance. The most influential facilitating factor for students was a well-accomplished course assignment and for teachers it was the successful administration of the online courses. Conclusions Several key factors have been identified that affected the attitudes of international health science students from LMICs and their teachers towards online education in China during the COVID-19 pandemic. To improve the online education outcome, medical schools are advised to promote the facilitating factors and cope with the barriers, by providing support for students and teaching faculties to deal with the anxiety caused by the pandemic, caring for the state of mind of in-China students away from home, maintaining the engagement of out-China students studying from afar and enhancing collaborations with overseas institutions to create practice opportunities at students’ local places.

Effects of Online Learning on Nursing Students in South Korea during COVID-19

“…One of the distinguishing characteristics of online learning is that students experience heightened autonomy in learning [9,32]. Li et al [14] reported that nursing students' learning attitude significantly affects their online learning outcomes. Therefore, self-regulation is considered a learner-centered construct that relates to how learners react to their situations.…”

“…This has been a new but increasingly common experience for nursing students as colleges have begun employing online learning courses more actively in Korea [35]. Accordingly, online learning has become a promising and effective model for undergraduate nursing students [14].…”

“…Oducado and Estoque [13] pointed out that some nursing skills are easier to teach in person than online. Li et al [14] reported that nursing students preferred face-to-face contact and interactions with classmates and in their education. Nursing students in their final semesters who were about to transition from nursing students to registered nurses were particularly concerned that online learning might negatively affect their readiness upon graduation [15].…”

COVID-19, the global education project and technology: Disrupting priorities towards rethinking education

“…Instructional design is of utmost importance. The expectation to lecturers to produce online learning material in a very short time without proper support and training negatively affected the academics during the pandemic (Li et al, 2021) and future situations should be avoided by equipped academics for online instructional design (Al-Nofaie, 2020). It must be student oriented, not only in terms of learning styles, and individualised learning, but must also consider the best way of assisting learners, within their realities.…”

Self-efficacy of online learning among nursing students during COVID-19 pandemic

“…As a consequence, the introduction of online system of education became a requisite to ensure the unhindered delivery of educational activities and this way, institutions were bound to reframe their curriculum accordingly. 6 This unexpected transition of educational system led to uncertainties among the nursing students. Many of the students expressed their concerns regarding the interruption of the programme following their removal from the clinical areas, which made them less confident and unsure about the progression of their course.…”