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Contents lists available at ScienceDirect

Teaching and Learning in Nursing

journal homepage: www.journals.elsevier.com/
teaching-and-learning-in-nursing

Nursing students’ and faculty members’ perspectives about online

learning during COVID-19 pandemic: A qualitative study
Izzeddin A. Bdair, RN, Ph.D.*
Al-Ghad International Colleges for Applied Medical Sciences Abha/KSA, Assir 62217, Saudi Arabia

A R T I C L E I N F O A B S T R A C T

Keywords: During the COVID-19 pandemic and mandatory lockdown, academic institutions have shifted to distance
Distance learning learning. This study aims to explore the nursing students' and faculty members’ perspectives of online learn-
Nursing students ing during the COVID-19 era. This qualitative study was conducted using a descriptive-phenomenology
Qualitative study method. Data were collected in August 2020 using a purposive sampling method and telephone semi-struc-
COVID-19
tured interviews based on the real-life experience of nursing students and faculty members with online
Lived experience
learning during the COVID-19. Data were transcribed verbatim and thematically analyzed using Spielberg’s
three-step process. Nursing students and faculty members were moderately satisfied with online learning
during the COVID-19 pandemic. However, conventional learning was the preferred option. Data were classi-
fied according to the three main studied domains: advantages, challenges, and recommendations. The results
revealed three themes for advantages, four themes for challenges, and four themes for recommendations.
The advantages themes include a flexible learning environment, academic achievement, and student-cen-
tered learning. The challenges themes were inadequacy, academic integrity, learning environment, and fam-
ily burden. The themes for recommendations were training, teaching, assessment, and quality monitoring.
The current study supports the use of online learning during this lockdown. Actions to improve online learn-
ing are essential to achieve more quality education.
© 2021 Organization for Associate Degree Nursing. Published by Elsevier Inc. All rights reserved.

Introduction Educational institutions are trying to apply different online modalities

The World Health Organization (WHO, 2020) has confirmed more
than 103 million COVID-19 cases worldwide and more than 368, 000
in Saudi Arabia. The emergence and spread of the COVID-19 pan-
demic have had dramatic effects on the education process globally.
Educational institutions were closed to ensure social distancing and
to reduce the risk of infection transmission on campuses. Murphy
(2020) stated that the COVID-19 crisis disturbed the health profes-
sions’ education and training. In an attempt to sustain the learning
process and achieve learning goals, educational institutions switched
from conventional to distance learning using online technology.
Recent technological advancements and the accessibility of devices
worldwide paved the way to adopt distance education strategies. Dis-
tance learning is the only option for many schools during the COVID-
19 pandemic, yet, it has been shown to be an effective and dynamic
method to deliver course content (Taylor et al., 2020). Online learning
is defined as a designed technology-based method for distributing,
tracking, and managing courses over the Internet (Keis et al., 2017).
*Corresponding author at: Assistant Professor of Critical Health Nursing & Head of
Nursing Department at Al-Ghad International Colleges for Applied Medical Sciences
Abha/KSA.
E-mail address: iabubdair@gc.edu.sa
to take full advantage of the learning experience by helping students
to engage in this new educational environment (Brown et al., 2020).
The online learning in Al-Ghad International Colleges for Applied
Medical Sciences has been occurring as a supportive strategy since
establishing the colleges 12 years ago. The colleges support the online
interactive learning. Students used the online modality before the
COVID-19 to take quizzes, submit their assignments, and received
the course materials. The applied health sciences rely more on con-
ventional learning strategies, in particular, for practice, demonstra-
tion, interviewing, communication skills, students’ assessment, and
using reactions to body language. The pure online learning was just
implemented at the beginning of the COVID-19 pandemic. At that
time, the information technology departments at colleges conducted
intensive training programs and workshops for both students and
faculty members on how to use the online platforms. Supportive
information technicians were always online with students and fac-
ulty members to resolve any technical issues.
Advantages and disadvantages of online learning
Distance learning is an important learning strategy. It provides stu-
dents with flexible learning opportunities to determine a convenient

https://doi.org/10.1016/j.teln.2021.02.008
1557-3087/© 2021 Organization for Associate Degree Nursing. Published by Elsevier Inc. All rights reserved.

Please cite this article as: I.A. Bdair, Nursing students’ and faculty members’ perspectives about online learning during COVID-19 pandemic: A
qualitative study, Teaching and Learning in Nursing (2021), https://doi.org/10.1016/j.teln.2021.02.008
JID: TELN
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2 I.A. Bdair / Teaching and Learning in Nursing 00 (2021) 1 7

time and place for studying (Sajid et al., 2016). The main advantages of Table 1
distance learning include remote delivery of learning materials, com- Demographic variables of nursing students and faculty members participated in this
study (N =20).
fort, accessibility, and easy management (Mukhtar et al., 2020). Almost
all participants in the Opeyemi et al., (2019) study reported that online Student (N =10) Faculty members (N =10)
learning is easy to use.
Gender: Gender:
In contrast, the transition from traditional to online learning has Male 5 Male 5
its challenges. Marshall and Wolanskyj-Spinner (2020) have shown Female 5 Female 5
that classroom learning is superior to online learning in terms of Educational level Academic rank
First-year 2 Professors 4
interaction and clarification. Health professions students often com-
Second-year 2 Lecturers 3
plain of learning difficulties through virtual learning activities that Third-year 3 Instructors 3
lead to low academic achievement. Rapid transformation from con- Fourth-year 3
ventional education to complete online learning and inattentive Previous experience of Previous experience of online
planning and training on using virtual class learning were cited online education education
Yes 0 Yes 0
among challenges to distance learning in the time of COVID-19
Partially 6 Partially 10
(Farooq et al., 2020). Another obstacle to implementing an effective No 4 No 0
virtual learning environment is the lack of information technology How much are you satisfied How much are you satisfied with
infrastructure (Bediang et al., 2013) and difficulty in sustaining aca- with online virtual learning online virtual learning
demic integrity (Mukhtar et al., 2020). Lastly, as most nursing stu- Highly satisfied 3 Highly satisfied 1
Moderately satisfied 4 Moderately satisfied 9
dents and faculty are female in the situation of this cultural context, Unsatisfied 3 Unsatisfied
engagement in other domestic activities during the lockdown puts
more burden on the teaching and learning process (Farooq et al.,
2020). The mentioned challenges might impede the adoption of
online virtual education (Chiasson et al., 2015). sample of 10 nursing students and 10 faculty members were invited
The inequities of online resources have been noticed during the to participate. The sample was composed of male and female faculty
COVID-19 pandemic as a consequence of educational reforms to online members with different academic credentials and rank, and male and
learning. For example, low socioeconomic status students and those female students from different academic levels from different college
who live in remote areas have an obstacle when considering engage- branches of private colleges for applied medical sciences to achieve
ment in online learning. There are some concerns regarding online the maximum variation (Table 1). The researcher is working at one of
learning including students joining online sessions using their devices these branches. Several actions were taken to minimize the potential
while they are parked in cars, faculty seeing students' private spaces risk of researcher bias such as including use of participants’ narrative,
such as doing class from bedrooms or engaging in other activities. checking the responses by another expert researcher and reviewing
findings with peers. The participants in the study were required to
Students' perspectives on online learning meet the following inclusion criteria: undergraduate nursing stu-
dents who were currently registered for classes, or employed faculty
Utama et al., 2020 reported that medical students have described members, enrolled in the online distance learning, and agreed to par-
their experience and performance of distance online learning as posi- ticipate in the study.
tive. According to Lovri
c et al., (2020), students reported mild fear of An interview guide was developed to explore the lived experience
getting the infection from the classroom and high fear from the clini- of nursing students and faculty regarding online distance learning in
cal setting, thus making online learning an appropriate option to terms of advantages, challenges, and recommendations. The inter-
lessen these fears. view guide consisted of open-ended questions to allow the respon-
Since COVID-19 is a new pandemic, a review of the literature has dent to explain their views and experiences. It was revised and
shown no available studies about nursing students’ perspectives dur- validated by two expert nursing researchers.
ing the COVID-19 period. However, previous studies indicated the Face-to-face and telephone semi-structured interviews were
importance of studying the lived experience of nursing students dur- administered to collect the data. The interview began by asking gen-
ing the COVID-19 crises, to ensure both students' safety and rigorous eral questions and proceeded to more details with concurrent data
teaching (Lovri
c et al., 2020; Schwartz et al., 2020). This qualitative analysis. All interviews were recorded and transcribed verbatim.
study aims to provide an in-depth analysis of nursing students' and Data were collected in August 2020 after the summer semester. On
faculty’s personal experiences regarding distance learning during average, the interview lasted 30 minutes. The researcher actively lis-
COVID-19 in terms of advantages, challenges, perspectives, and rec- tened to the interviewees' descriptions during the interview and to
ommendations to improve the distance learning experience. the recorded interviews multiple times to extract themes. The num-
With the increased adoption of online modalities during COVID- ber of interviewed students and faculty members was determined by
19 as an alternative to the classroom, it is necessary to assess their data saturation where collection of more data did not reveal any fur-
effectiveness from the users' perspectives. In this study, the purpose ther insights into the studied phenomenon for all themes. Online
was to understand the lived experiences of nursing students and fac- learning had been implemented for two semesters - second (spring)
ulty members regarding online distance learning. Previous studies and summer at the time of data collection.
that have been conducted on this topic were rare, so the advantages, The data were thematically analyzed using Spielberg’s three-step
challenges, and recommendations to improve online distance learn- process: intuiting, analyzing, and describing (Spielberg, 1975). Data
ing were not fully explored. The best method to understand this analysis began after the first interview and continued concurrently
experience was through descriptive-qualitative phenomenology. with the interviews. After data analysis, participants were asked to
confirm the emerged themes to ensure the rigor of the findings. The
Materials and methods data analysis process was reviewed by an external researcher to ver-
ify accuracy and credibility.
This study aimed to explore the lived experiences of nursing stu- Following the research ethical guidelines, Institutional Review
dents and faculty members regarding online distance learning using Board (IRB) approval was obtained from the college research commit-
a descriptive qualitative phenomenology approach. A purposeful tee. Informed consent was obtained for participation in the research

Please cite this article as: I.A. Bdair, Nursing students’ and faculty members’ perspectives about online learning during COVID-19 pandemic: A
qualitative study, Teaching and Learning in Nursing (2021), https://doi.org/10.1016/j.teln.2021.02.008
JID: TELN
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I.A. Bdair / Teaching and Learning in Nursing 00 (2021) 1 7
and recording of the interviews. The objectives and research ques-
tions were explained to each participant.
The scientific rigor of the findings was considered through proce-
dures to ensure the trustworthiness of the data. An expert nursing
qualitative researcher reviewed the research questions and checked
the transcripts for accuracy. Second, participants checked and veri-
fied the exact words of the transcripts after interviews to confirm
accuracy. Third, participants’ words were used as much as possible to
establish that the findings were based on participants’ responses, not
from the researcher’s own bias. Fourth, verification of the themes
identified by the researchers was done by the participants them-
selves to attain confirmability. Finally, an audit trail was kept to help
in data analysis, presentation, and findings.
Results
Demographic data of study participants are shown in Table 1.
From interviews with the 20 participants, 100 initial codes were
extracted. Based on data comparisons and analysis, excerpts were
classified according to the three main studied domains: advantages,
challenges, and recommendations. Three main themes were deter-
mined for advantages, four themes for challenges, and four themes
for recommendations. The advantages themes included a flexible
learning environment, academic achievement, and student-centered
learning. The challenges themes were inadequacy, academic integ-
rity, learning environment, and family burden. The recommendations
themes were training, teaching, assessment, and quality monitoring.
Online learning has been implemented totally for two semesters
at Al-Ghad International Colleges for Applied Medical Sciences. Many
students have prior experience with partial online delivery of learn-
ing while all faculty members were familiar with online learning and
have been using this strategy partially in parallel with the conven-
tional methods in the previous academic experiences. Overall, both
students and faculty members were moderately satisfied with the
new online teaching experience and found it an efficient and effective
alternative method. A student stated that “the shift to online learning
helped me continue my study, sharpened my technological compe-
tencies, opened a door to a wide range of information, and definitely
helped in maintaining our safety; but I really missed the direct com-
munications with colleagues, nurses, and instructors, and that’s
affecting my learning somehow. Generally, I am moderately satisfied
with this experience”. Another student stated that, “I like the ability
to listen to the recorded lectures many times, but I was afraid of using
online learning when I faced some technical issues especially during
the exams. I can say I am moderately satisfied with online learning
and pretty sure I will be more satisfied with more practice”. The stu-
dents and faculty members acknowledged using mixed education
rather than pure online learning. A faculty stated, “I was moderately
satisfied with the online learning process, nevertheless, I think it is
more appropriate for postgraduate studies”. A student stated that
“online learning fits theoretical nursing education but for sure not for
practice”.
Advantages
Online learning was an important alternative teaching strategy
during the COVID-19 lockdown. The advantages of online learning
were described in three themes that include ‘flexible learning envi-
ronment’, ‘academic achievement’, and ‘student-centered learning’.
Flexible learning environment
Both students and faculty members highlighted that the main
advantage of online learning lies in its flexibility where it can be con-
ducted at a convenient time. It helps ensure remote learning wher-
ever there is internet access. A faculty stated, “Students can create
Please cite this article as: I.A. Bdair, Nursing students’ and faculty members’ perspectives about online learning during COVID-19 pandemic: A
qualitative study, Teaching and Learning in Nursing (2021), https://doi.org/10.1016/j.teln.2021.02.008
[m5GUS;March 13, 2021;12:17]
3
their learning environment as per preferences”. Online learning saves
time, effort, and resources; the faculty and students do not use trans-
portation and college resources. Bridging working students are stu-
dents who have a two-year technical diploma and continue their
studies to baccalaureate program. One bridging student opined that
“Online learning fits me and other working students to manage our
work and our study". Easy administration through user-friendly
applications is another advantage of adopting online learning. Stu-
dents stated that online learning opened more channels of communi-
cation with teachers. A faculty stated when asked about the
perceived advantages of online learning, “Innovation, the use of new
technologies gives teachers the freedom to experiment in their teach-
ing practice, and the ability to make changes if something does not
work".
Academic achievement
Students' academic achievement was improved during shifting to
online learning. A student stated, "Listening to recorded lectures many
times up to a satisfactory level of understanding helps me to get higher
scores". This strategy of learning is appropriate for students with social
phobia to perform better. A faculty stated, "The most important advan-
tage of online learning was maintaining teaching continuity". Using
online learning during COVID-19 improved students' online learning
skills that support the future adoption of online learning. The online
learning environment is controlled by the teacher, preventing any pos-
sible student interruption. Meanwhile, if students have questions or
are unclear on a topic or concept, they can raise their hands and ask
permission to participate. This helps in creating a more suitable learn-
ing environment for better understanding.
Student-centered learning
The student is always the center of the learning process. The
adoption of an online learning strategy enables students to become
self-directed learners. A student said, “My experience with online
learning provided me with the chance to be a more independent
learner". Online learning enables students to review recorded lec-
tures many times. A faculty supports this idea and adds, "Motivating
the students is a key in helping students to be more of a self-learner".
Online learning provides students with broad learning websites over
the internet.
Challenges
Inadequacy
Implementation of online learning has fundamental requirements
such as infrastructure, training of end-users, and establishing teach-
ing and assessment guidelines to ensure a high-quality learning envi-
ronment. Among reported challenges, a lack of control over
evaluation parameters such as exams, quizzes, and assignments. A
faculty stated that “The virtual online environment during student
evaluation is not controlled and students can get access to course
material. Lack of such control constitutes an obstacle". Both students
and faculty members highlighted that lack of training on using virtual
class learning was a problem that was relieved with time and prac-
tice. A student said that, “I complained of lack of motivation, atten-
tion, and feedback during studying at home; I had these many
times". Inadequate internet coverage and loss of connectivity espe-
cially in rural areas was another challenge. Since the transition to
pure online learning was abrupt, faculty reported some difficulties
due to a lack of well-established student assessment tools. Also, stu-
dents reported that teachers used different online applications to
deliver lectures due to the lack of a standard platform and students
faced a challenge in mastering all these applications. Lack of students’
interaction with other students and with faculty is also reported as a
challenge for both students and faculty members.
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Academic integrity
Maintaining academic integrity is highly essential to ensure a
robust learning process. All faculty and students mentioned that
online learning is inappropriate to teach practical competencies and
hands-on skills. A student reported, "Nursing practice is the core of
the nursing profession, without hands-on we cannot master the
required skills; even the theoretical knowledge needs to be linked to
practice, and this is a real challenge we faced during our experience".
Interaction between teacher and students through body language
and eye contact is essential for a successful teaching process that is
impossible through online learning. Another challenge for online
learning is the breach of academic veracity through plagiarism and
cheating issues. A faculty stated, "The learning environment is not
controlled during exams and preparing assignments as students
might misbehave to access the content during assessment”.
Learning environment
As there are many advantages to the online learning environment,
many challenges are also reported. In the virtual learning environ-
ment, it is difficult for teachers to maintain student engagement. A
faculty said, “Through using online learning, students might be dis-
tracted by internet applications, programs, calls, and messages". Stu-
dents reported problems with understanding the dynamic online
lecture. A student stated, "As a new experience and due to sudden
transition from conventional to online learning, we faced some tech-
nical issues in dealing with the platforms in the beginning, especially,
during exams. It was a stressful experience". As an alternative, stu-
dents were asked to submit extra assignments as a method of evalua-
tion; thus, students perceived assignment overload as a challenge.
Online learning limits teamwork and social interaction. A student
stated, "As a nursing student, I do prefer conventional learning
because I learn from my interaction with my teachers and colleagues
more than just theoretical knowledge".
Family burden
Online learning required both a device and an internet connec-
tion. The financial burden on the family to buy a new technological
device and internet access is a challenge for some families. A male
student stated “offering the electronic device for each student in my
family was overwhelming to my family”. Furthermore, a female pro-
fessor stated "A quiet learning environment for students at home is
important, but it is not always available especially when there are
many students". A female housewife student stated, “studying at
home is being distracted by other house obligations and kids". This
challenge was also highlighted by faculty members.
Recommendations
Teachers and students made many recommendations to improve
the online experience. These recommendations lie in four main
themes.
Training
As a new experience, faculty and students highlighted the impor-
tance of conducting training sessions for both faculty members and
students on using e-learning and assigning an information technol-
ogy technician to follow-up on the technical problems.
Teaching
Clinical instructors and students in clinical courses suggested con-
ducting review classes for psychomotor skills and core competencies
after the COVID-19 pandemic. To avoid distraction from mobile appli-
cations and to achieve better viewing the content of the lectures, a
faculty said, "I do recommend using a desk computer rather than
mobiles". Another faculty stated, “Limiting the number of students
Please cite this article as: I.A. Bdair, Nursing students’ and faculty members’ perspectives about online learning during COVID-19 pandemic: A
qualitative study, Teaching and Learning in Nursing (2021), https://doi.org/10.1016/j.teln.2021.02.008
[m5GUS;March 13, 2021;12:17]
per class for example 15 students, helps the teacher to control the
online lectures and maximize benefits". As students complain of
workload, they recommend reducing the academic load in terms of
content and time.
Assessment
Evaluating students' understanding and grading them accordingly
is a core requirement in the teaching process. Faculty members and
students suggested using standardized assignments in terms of
nature, numbers scoring, and assessment tools. A faculty recom-
mended, “Checking students’ submitted written assignment using
plagiarism software detectors or oral discussion with the students to
ensure students’ understanding”.
Quality monitoring
Quality indicators should be monitored to ensure a rigorous
teaching process. Among the proposed recommendations to enhance
quality, it was suggested that all subjects use one standard software
application and follow-up on the students' attendance. A faculty
mentioned, “Assigning grades for simple questions during the class
to ensure attendance, attention and active participation is highly rec-
ommended and I found it effective”. Another faculty said, “To ensure
objective assessment, control the exams by setting limited time, a
wide variety of questions and one-way navigation, and implement
different forms of exam helps in preventing students to access the
course content during evaluation". Detecting cheating and plagiarism
through software programs is also recommended. Measuring the
intended learning outcomes is a key step in achieving the online
learning process goals.
Discussion
Academic institutions worldwide have converted to online learn-
ing suddenly during the lockdown due to the unprecedented COVID-
19 pandemic. This study explored nursing students' and faculty
members' perspectives and lived experiences of online learning in
light of advantages, challenges, and recommendations for improve-
ment. The students and faculty members were moderately satisfied
with the new online teaching experience and found it an efficient
and effective alternative method. Similar results were obtained from
other studies, where faculty members were satisfied with the online
learning experience (Lovri
c et al., 2020). However, the students and
faculty members praised hybrid education rather than completely
online, since the nursing profession depends more on practical skills
that require hands-on to master.
The main advantage of online learning was flexibility; teachers
and students showed a consensus that online learning maintained
the continuity of the learning process. It ensured the distance learn-
ing at a convenient time from homes where students can easily
access the virtual class. These results were supported by Keis et al.
(2017) that online learning is more flexible than the conventional
method. Furthermore, the ease of lecturing and administering exams
also supported the adoption of this technology-based learning strat-
egy. These findings are concurrent with Opeyemi et al. (2019) results
where the vast majority of students perceived that online learning
platforms are easy to use. This might be viewed considering that
most of these applications are user friendly and the younger genera-
tions are savvy in using technology. Due to easy and frequent access
to the recorded lectures along with studying within convenient con-
ditions, students’ academic achievements improved. Since students
started to learn more independently, they become more motivated
and self-directed learners. Mukhtar et al. (2020) supported these
findings that online learning enables students to learn at any time
and helps them to be self-directed learners. Since an internet-based
environment has a wide variety of teaching materials presented in
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Table 2
Advantages, limitations and recommendations of online-learning.

Themes Excerpts

Flexible learning environment
Academic achievement
Student centered learning
Advantages
1. User friendly applications.
2. Lectures at convenient time.
3. Innovative strategy with using large variety of resources.
4. Easy administration and conducting exams.
5. Flexible lectures schedule.
6. Maintain teaching continuity.
7. Accomplishing and submitting tasks fast.
8. Availability and accessibility of technological devices.
9. Save time effort and resources.
10. Easy communication with teachers.
11. Cost effective strategies that use online materials.
12. Remote learning from home.
13. Appropriate for workers students (bridging).
14. Improve students’ academic achievement.
15. Studying recorded lecture many times up to satisfactory level of understanding.
16. Connection to a wide variety of learning resource over the internet.
17. It enables students with social phobia to achieve better.
18. Support the long-distance teaching for future adoption.
19. Improve students’ online learning skills.
20. Control learning environment from student interruption.
21. Students become self-directed learner and motivated.
22. Provide students with broad learning websites over the internet.
23. Ability to review recorded lectures many times.

Challenges

Inadequacy 1. Lack of students’ feedback.

2. Lack of control over evaluation parameters (exams, quizzes and assignments).
3. Lack of learning environment at home (lack of motivation, impaired attention).
4. Student assessment difficulties.
5. Inadequate Internet coverage and loss of connectivity especially in rural areas.
6. Students lack of proficiency in using the software platforms.
7. Lack of students’ interaction.
8. Lack of training on using virtual class learning.
9. Using different platforms to deliver lectures.
10. Unavailability of devices.
Academic veracity 11. Inappropriate to teach practical competencies
12. Lack of professionalism through student’s interruption
13. Lack of body language communication and eye contact between teachers and students
14. Plagiarism and cheating issues as students are not fully controlled to access content.
Learning environment 15. Difficult maintaining of student engagement.
16. Problems with understanding the dynamic online lecture.
17. Technophobia (fear of disconnection especially during exams).
18. Lack of rules and guidelines of online learning process.
19. Limit teamwork and social interaction.
20. Assignments overload.
21. Unpreparedness to the switch to online learning abruptly.
22. Stressful new experience.
23. Distraction by Internet applications and programs.
24. Not appropriate for those with health problems that cannot sit for long time in front of computer.
Family burden 25. Inability to provide a quite learning environment at home especially when there are many students.
26. Financial burden to buy a new technological device.
27. Domestic obligation for workers and housewives, students and teachers.

Recommendations

Training 1. Training sessions for both faculty members and students on using e-learning.
2. Following up the technical problems.
Teaching 3. Implementing online learning partially in parallel with conventional learning.
4. Using desk computer rather than mobiles.
5. Limiting number of students per class.
6. Reducing academic load in terms of content and time.
7. Increasing interactivities with inactive students.
8. Achieving learning outcomes.
9. Review classes for core content at the end of each class.
10. Review workshops for core competencies after pandemic or under strict precautions.
Assessment 11. Standardization of assignment in term of nature, numbers and scoring.
12. Using objective assessment tools.
13. Checking students’ understanding of submitted written assignment using plagiarism software detectors or oral discussion with the students.
Quality monitoring 14. Dual students’ evaluation through double-checking.
15. Using standard software platform.
16. Following up students’ attendance.
17. Assigning grades for simple questions during the class to ensure attendance, attention and active participation.
18. Control the exams by setting limited time, wide variety of questions and one-way navigation.

Please cite this article as: I.A. Bdair, Nursing students’ and faculty members’ perspectives about online learning during COVID-19 pandemic: A
qualitative study, Teaching and Learning in Nursing (2021), https://doi.org/10.1016/j.teln.2021.02.008
JID: TELN
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6 I.A. Bdair / Teaching and Learning in Nursing 00 (2021) 1 7
different interactive ways that match students' needs, students found
it more beneficial. Additionally, using visual learning helps students
more than auditory learning to understand the course materials.
Studying at home, which eliminates commuting time, provides stu-
dents more time to study. Considering all these factors, students’ aca-
demic achievements, as evidenced by their exam scores, were
improved. This finding was supported by the work of Opeyemi et al.
(2019) who affirmed that online learning increases access to educa-
tion and enhances students' achievement.
Study subjects highlighted that lack of proficiency in using the
software platforms along with the lack of training on using virtual
class learning and platforms was among the challenges at the outset
of transition to online learning. Farooq et al. (2020) found that the
lack of students' and faculty members' preparedness and training
was an obstacle to engage in online learning during the early COVID-
19 pandemic. This might be due to the sudden transition and previ-
ous inexperience in using online learning before the pandemic. How-
ever, this problem was resolved gradually with more practice and
training sessions. Both students and the faculty members viewed
that online learning focuses on the theoretical part rather than psy-
chomotor skills. Nursing students, particularly bridging students, are
aware of the importance of practice in clinical settings to acquire
nursing competencies. However, some alternatives to overcome
teaching skills were used including teaching videos and online simu-
lated case scenarios. Lack of students' interaction and feedback was
also reported as a limitation of online learning. Longhurst et al.
(2020) have shown that students' engagement was reduced using
online learning. Increased interactivities and two-way communica-
tion to facilitate and deepen understanding were supported by Wang
and Wu (2008). Web-based learning depends on the availability of
devices and a good internet connection. Mukhtar et al. (2020)
reported that improving internet coverage might help overcome this
challenge. Students complain of a lack of motivation and impaired
attention when attending their virtual class at home. From a faculty
point of view, they complain of a lack of control over evaluation
parameters such as exams and assignments and perceived student
assessment through online platforms as a difficult task. Chiasson and
colleagues, (2015) studied faculty perceptions toward moving to
online instruction and found that challenges to the online environ-
ment may delay its implementation.
Students and the faculty members made many recommendations
to enhance the students' learning experience. The administration
needs to set up the online learning instructions including attendance,
interaction, and assessment tools. Training and orientation sessions
are highly recommended to improve faculty members' and students’
online learning skills and tools. According to faculty members, reduc-
tion of the lecture time, cognitive loads, and class capacity are appro-
priate steps to improve students’ attention, interaction and
participation, and ensure achieving learning outcomes (Mukhtar et
al., 2020). Using a desk computer rather than mobiles also helps the
students to pay more attention and less distracted by incoming calls.
These actions were documented in the literature (Bradbury, 2016).
Review classes for core content and psychomotor competencies after
the pandemic or under strict safety precautions helps to ensure an
effective learning process. Student assessment is an essential part of
education, so implementing standard assessment tools, and using
plagiarism software detectors or oral discussion with the students
are key recommendations to maintain an objective assessment dur-
ing online learning. Using standard software applications, following-
up attendance, and control of the exams by setting strict time limits,
a wide variety of questions and one-way navigation are key actions
to ensure a high-quality online learning assessment. These findings
are consistent with the work of Stewart, (2008) who opines that set-
ting solid rules and regulations is important for successful online
learning. Finally, but equally important, institutions should invest in
Please cite this article as: I.A. Bdair, Nursing students’ and faculty members’ perspectives about online learning during COVID-19 pandemic: A
qualitative study, Teaching and Learning in Nursing (2021), https://doi.org/10.1016/j.teln.2021.02.008
[m5GUS;March 13, 2021;12:17]
information technology infrastructure and training to establish a
well-designed online learning system that serves technology-based
education.
All extracted themes of advantages, challenges, and recommenda-
tions of online learning are summarized in Table 2.
Conclusion
Nursing students' and faculty members' experiences indicated
that they were generally satisfied with online learning as an alterna-
tive strategy during the COVID-19 pandemic. Converting to online
learning during the COVID-19 pandemic was necessary to limit the
spread of the infection. Overall, the study findings revealed that the
impact of the COVID-19 pandemic on online learning was positive.
Online learning strategy served well as an alternative during the pan-
demic. Just as there are challenges to conventional teaching methods
anda need to continuously improve, there is a need to continuously
improve the online teaching competencies. The recommendations to
overcome these challenges are essential to make online learning
more effective.
High-quality learning is not limited to classroom attendance.
Online teaching strategies during this pandemic served to provide a
high-quality alternative too, considering its numerous advantages.
This crisis created a new motivation to adapt to this valuable teaching
strategy. Taking actions to prepare institutions and the work force
and students for online learning, and well-established infrastructure,
is an important for future implementation. Despite its limitations, the
respondents expressed that their confidence in the effectiveness of
online learning was significantly improved with practice. Therefore,
the online learning method could be improved to be more fully
implemented in nursing education. Based on the results of this study,
stakeholders must evaluate online learning from different perspec-
tives. More studies are recommended in this regard that include
using simulation labs, teacher’s motivation, technology acceptance,
and infrastructure readiness.
Limitations
This study has several limitations. First, the perspectives of stu-
dents with disabilities during the transition to online courses were
not addressed. Additional limitations are potential researcher bias
and participant self-selection. Furthermore, only the experiences of
nursing students and teachers have been extracted in this study from
a small sample size, so it is recommended to conduct further studies
that investigate more samples from different regions that address the
other aspects of online learning including stakeholders, families, and
students from different specialties. Data were collected from four col-
lege branches where the researcher is working in one of them. How-
ever, many actions to minimize this risk of bias were taken.
Declaration of interest statement
The author declares there are no competing interests.
References
Bediang, G., Stoll, B., Geissbuhler, A., Klohn, A. M., Stuckelberger, A., Nko’o, S., &
Chastonay, P. (2013). Computer literacy and E-learning perception in Cameroon:
The case of Yaounde faculty of medicine and biomedical sciences. BMC Medical
Education, 13(1), 57. doi:10.1186/1472-6920-13-57.
Bradbury, N. A. (2016). Attention span during lectures: 8 seconds, 10 minutes, or more?
Advances in Physiology Education, 40(4), 509–513. doi:10.1152/advan.00109.2016.
Brown, M., McCormack, M., Reeves, J., Brook, D. C., Grajek, S., & Alexander, B. (2020).
Educause horizon report teaching and learning edition. Louisville, CO: EDUCAUSE.
Chiasson, K., Terras, K., & Smart, K. (2015). Faculty perceptions of moving a face-to-face
course to online instruction. Journal of College Teaching & Learning (TLC), 12(3).
doi:10.19030/tlc.v12i3.9315 321-240.
JID: TELN
ARTICLE IN PRESS
I.A. Bdair / Teaching and Learning in Nursing 00 (2021) 1 7
Farooq, F., Rathore, F. A., & Mansoor, S. N. (2020). Challenges of online medical educa-
tion in pakistan during COVID-19 Pandemic. Journal of the College of Physicians and
Surgeons Pakistan: JCPSP, 30(6), 67–69. doi:10.29271/jcpsp.2020.Supp1.S67.
€
Keis, O., Grab, C., Schneider, A., & Ochsner, W. (2017). Online or face-to-face instruc-
tion? A qualitative study on the electrocardiogram course at the University of Ulm
to examine why students choose a particular format. BMC Medical Education, 17
(1), 194. doi:10.1186/s12909-017-1053-6.
Longhurst, G. J., Stone, D. M., Dulohery, K., Scully, D., Campbell, T., & Smith, C. F. (2020).
Strength, Weakness, Opportunity, Threat (SWOT) analysis of the adaptations to
anatomical education in the United Kingdom and Republic of Ireland in response
to the COVID-19 pandemic. Anatomical Sciences Education, 13(3), 301–311.
doi:10.1002/ase.1967.
 & Vcev, A. (2020). Studying during the COVID-19 pan-
Lovri
c, R., Farci
c, N., Miksi
c, S.,
demic: A qualitative inductive content analysis of nursing students’ perceptions
and experiences. Education Sciences, 10(7), 188–206. doi:10.3390/
educsci10070188.
Marshall, A. L., & Wolanskyj-Spinner, A. (2020). COVID-19: Challenges and opportuni-
ties for educators and generation Z learners. Mayo Clinic Proceedings: 95
(pp. 1135 1137). Elsevier. doi:10.1016/j.mayocp.2020.04.015.
Mukhtar, K., Javed, K., Arooj, M., & Sethi, A. (2020). Advantages, limitations and recom-
mendations for online learning during COVID-19 pandemic era. Pakistan Journal of
Medical Sciences, 36(COVID19-S4). doi:10.12669/pjms.36.COVID19-S4.2785.
Murphy, B. (2020). COVID-19: How the virus is impacting medical schools MAR 18.
Available from: https://www.ama-assn.org/delivering-care/public-health/covid-
19-how-virus-impacting-medicalschools.
Please cite this article as: I.A. Bdair, Nursing students’ and faculty members’ perspectives about online learning during COVID-19 pandemic: A
qualitative study, Teaching and Learning in Nursing (2021), https://doi.org/10.1016/j.teln.2021.02.008
[m5GUS;March 13, 2021;12:17]
7
Opeyemi, O. Z., Adeyemi, A. A., Olajuwon, T. D., Nike, O., & Oloruntosin, B. S. O. (2019).
Perception of nursing students towards online learning: A case study of lautech
open and distance learning centre, Ogbomoso, Oyo State, Nigeria. Galore Interna-
tional Journal of Health Sciences and Research, 4(4), 23–30.
Sajid, M. R., Laheji, A. F., Abothenain, F., Salam, Y., AlJayar, D., & Obeidat, A. (2016). Can
blended learning and the flipped classroom improve student learning and satisfac-
tion in Saudi Arabia? International Journal of Medical Education, 7, 281–285.
doi:10.5116/ijme.57a7.83d4.
Spielberg, H. (1975). Doing phenomenology: Essays on and in phenomenology. Africa:
Springer Netherlands.
Schwartz, A. M., Wilson, J. M., Boden, S. D., Moore, T. J., Jr, Bradbury, T. L., Jr, &
Fletcher, N. D. (2020). Managing resident workforce and education during the
COVID-19 pandemic: Evolving strategies and lessons learned. JBJS Open Access, 5
(2), e0045. doi:10.2106/JBJS.OA.20.00045.
Stewart, D. (2008). Classroom management in the online environment. Journal of
Online Learning and Teaching, 4(3), 371–374.
Taylor, D., Grant, J., Hamdy, H., Grant, L., Marei, H., & Venkatramana, M. (2020). Trans-
formation to learning from a distance. MedEdPublish, 9(1), 76. doi:10.15694/
mep.2020.000076.1.
Utama, M. R., Levani, Y., & Paramita, A. L. (2020). Medical students' perspectives about
distance learning during early COVID 19 pandemics: A qualitative study. QanunMe-
dika-Medical Journal Faculty of Medicine Muhammadiyah Surabaya, 4(2), 255–264.
Wang, S. L., & Wu, P. Y. (2008). The role of feedback and self-efficacy on web-based
learning: The social cognitive perspective. Comparative Education, 51(4), 1589–
1598. doi:10.1016/j. compedu.2008.03.