Adv Physiol Educ 46: 375–388, 2022.

First published May 12, 2022; doi:10.1152/advan.00023.2022

TEACHING INNOVATIONS

A blended learning exercise physiology theory module that supports student

autonomy and improves academic performance
Brianna L. Julien,1 Kathy Tangalakis,2 Alan Hayes,3 and Louise Lexis1
1
Department of Microbiology, Anatomy, Physiology and Pharmacology, School of Agriculture, Biomedicine and Environment,
La Trobe University, Melbourne, Victoria, Australia; 2First Year College, Institute for Sustainable Industries and Liveable Cities,
Victoria University, Melbourne, Victoria, Australia; and 3Institute of Health and Sport (IHeS), College of Health and
Biomedicine, Victoria University, Melbourne, Victoria, Australia

Abstract
A limited number of studies have explored the impact of blended exercise physiology theory curricula on student learning and
experience. This study aimed to investigate the impact of an exercise physiology blended learning theory module on student
performance, engagement, and perceptions. The module, which comprised a range of elements (student guide, lecturer-
recorded videos, supplementary videos, formative quizzes, workshops, and discussion forum), was implemented in a third-year
subject taken by students in nonspecialist undergraduate science, technology, engineering, and mathematics (STEM) degrees.
Students chose which elements to engage with to support their learning. Exam performance was assessed by comparing exam
marks from fully face-to-face delivery to the blended delivery with an independent t test. Student perceptions were determined
via an end-of-module questionnaire comprised of Likert-scale questions and open-ended questions. Descriptive statistical analy-
sis was conducted on the Likert-scale responses, and qualitative content analysis was conducted on the open-ended responses.
Student engagement with online resources was determined through analysis of access statistics from the learning management
system. Student exam marks in the blended learning student group were significantly higher (P < 0.0001) than in the face-to-
face group, even though the questions were of a higher Bloom’s level in the blended learning group. Students preferred
blended delivery over fully face-to-face delivery. Most students accessed the student guide, lecturer-recorded videos, and
quizzes, with supplementary videos, workshops, and discussion forums accessed by fewer students. In conclusion, a blended
exercise physiology theory module improved student exam performance and was positively perceived by students, and engage-
ment with the elements of the module was varied.
NEW & NOTEWORTHY Few studies have explored the impact of blended delivery of exercise physiology theory curricula on
student learning and experience. This study investigated the impact of a novel blended model on student learning and experi-
ence. The module comprised a range of elements (student guide, lecturer-recorded videos, supplementary videos, formative
quizzes, workshops, and discussion forum), where students were able to choose which elements to engage with to support their
learning.

flexible learning; student engagement; student satisfaction

INTRODUCTION was being questioned, and there were already suggestions of

The COVID-19 pandemic and the resultant rapid imple-
mentation of remote and blended teaching has reignited
debate about the role of face-to-face lectures in higher edu-
cation. This is despite living in an era in which the focus has
shifted to student-centered teaching and we have the tech-
nology and infrastructure to support efficient and effective
content delivery in a broader range of synchronous and
asynchronous formats. Both faculty and students may be
reliant on the lecture technique because it is familiar, com-
fortable, teacher centered, and cost effective and entails little
active student participation (1). Interestingly, as early as
1970, the efficiency of the lecture as a means of instruction
suitable substitutes such as the provision of lecture scripts
(2). In addition, there is no consensus on the relation
between attendance at lectures and student performance on
assessments, with differences across disciplines and study
methodologies. Horton and colleagues (3) found that lecture
attendance was only weakly correlated with academic per-
formance and not related to learning style in a second-year
physiology course. Weak positive correlations between lec-
ture attendance and performance have similarly been
observed in students undertaking sport degrees (4) and nurs-
ing students in a pathophysiology subject (5), and Davis and
colleagues (6) found no correlation in biochemistry and
pharmacology cohorts. A systematic review by Mthimunye

Correspondence: L. Lexis (L.Lexis@latrobe.edu.au).

Submitted 27 January 2022 / Revised 17 March 2022 / Accepted 2 May 2022

1043-4046/22 Copyright © 2022 the American Physiological Society. 375

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 BLENDED LEARNING SUPPORTS AUTONOMY AND IMPROVES PERFORMANCE
and Daniels (7) found that lecture attendance was only 1 of
16 significant predictors of academic performance among
nursing students. With little correlation, and generally fall-
ing lecture attendance in the digital age, where lectures are
recorded and can be accessed anytime, it is little surprise
that other teaching options have emerged.
Blended learning is becoming a standard delivery option
and, for many, is a “best of both worlds” model that com-
bines the most effective aspects of face-to-face and online
teaching (8). Blended learning refers to methods that com-
bine different learning theories and media types (9) and
practices with varying proportions and sequences of face-to-
face and online activities (10). The purported benefits of
blended learning include that it is an effective pedagogy (11–
13), requires active learning and is more student centered
than traditional lectures (14, 15), is cost effective (13), pro-
vides flexibility for learners (13, 16) and control over the
time, place, path, or pace of learning (17), allows interaction
between staff and students (18), ensures student interaction
and learner engagement (19), and is valuable for different
types of learners (20). The incorporation of online technol-
ogy into physiology subjects has been found to enhance the
student experience and produce student learning outcomes
at least equal to those attained in traditionally delivered
physiology courses (21–25). Blended learning allows instruc-
tors to incorporate a range of online tools to support learn-
ing, including quizzes, chat sessions, and forums, which
may better suit the needs of a diverse student population (12)
and this generation of students.
The increased control over their own learning that stu-
dents report as a benefit of blended learning results from the
increased student autonomy associated with this approach.
A model that requires students to be less dependent on
teachers is more likely to foster self-management and self-
reliance skills that will be valuable in the world of work and
for life-long learning (26). If students are not given opportu-
nities to make decisions about their own learning, including
about their learning needs and activities, they are less likely
to develop skills in planning and organizing (26). A range of
terms are used to describe approaches designed to have stu-
dents take greater responsibility for their own learning,
including self-directed learning, learner-controlled instruc-
tion, and participatory learning (27). According to self-deter-
mination theory (SDT), autonomy is one of the three innate
psychological needs proposed to enhance intrinsic motiva-
tion, self-regulation, and well-being (28). Students who feel
autonomous are more likely to see the value in learning tasks
and therefore be more engaged in the activity (29, 30). For
students to successfully engage in blended learning, they
require several self-regulation skills including organization,
discipline, time management, skill in using technologies to
support their learning, and self-efficacy to control their
learning (31). In their systematic review, Rasheed and col-
leagues (32) identified self-regulation as one of the most
common challenges identified by students undertaking
blended/online learning. Therefore, as educators work to-
ward contemporary teaching practices, it is important to
consider the extent to which the resulting environments pro-
mote autonomous learning.
Although blended learning in higher education has
received a great deal of attention in the literature over
376 Advances in Physiology Education
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recent years, there have been limited studies on student
learning and perceptions of blended exercise physiology
theory curricula. McFarlin (22) replaced a traditional exer-
cise physiology theory course comprised of face-to-face
lectures with a blended course format (combination of
recorded online and face-to-face lectures) and found that
students’ final grades were higher in the blended format
compared with traditional delivery. The traditional format
comprised two 1.5-h weekly face-to-face lectures, whereas
the blended format comprised a weekly 1.5-h recorded
online lecture providing basic information and incorpo-
rating an assessable quiz, followed by an in-class lecture
(1.5 h) providing more advanced material and using audi-
ence-response technology. Informal student feedback
from course evaluations showed that students studying in
blended format preferred the self-paced nature and the
ability to review content as frequently as they wanted (22).
To our knowledge, no studies have been published on
blended exercise physiology curricula that have been pur-
posefully designed to include a range of elements where
students have the autonomy to choose which elements to
engage with to support their learning.
Therefore, we developed and implemented an exercise
physiology blended theory module comprised of a range of
elements (student guide, lecturer-recorded videos, supple-
mentary videos, formative quizzes, workshops, and discus-
sion forum) for third-year undergraduate students in
nonspecialist health-related science, technology, engineer-
ing, and mathematics (STEM) degrees.
The objectives for this study were to determine
1) The impact of teaching exercise physiology theory in
blended mode compared with fully face-to-face on stu-
dent exam performance
2) Student perceptions of an exercise physiology blended
theory module
3) Student engagement with the online resources in an
exercise physiology blended theory module.
METHODS
Participants and Context
The exercise physiology theory module was embedded
into a final-year Human Physiology core subject in the
Human Physiology and Anatomy major. Human physiology
refers to the study of how the human body works and is
focused on the chemistry and physics underpinning basic
body functions, from how molecules behave in cells to how
organs and body systems function. Exercise physiology is
the study of the body’s responses to physical activity, and
this can include acute responses to exercise such as
increased energy use, heart rate, and breathing rate or adap-
tations to chronic exercise such as increased muscle mass
and improved cardiorespiratory fitness. Human and exercise
physiology are topics relevant to students in a range of
degrees. The topics covered in the modules are shown in
Table 1, along with relevant chapters from the prescribed
text (33). Between 2010 and 2019, 968 students were enrolled
in the subject, comprising 67% enrolled in the Bachelor of
Health Sciences, 20% in Biomedical Science, 9% in Human
Nutrition, and 4% in other science degrees. Students in
 BLENDED LEARNING SUPPORTS AUTONOMY AND IMPROVES PERFORMANCE

Table 1. Exercise physiology topics covered in traditional the subject learning management system (LMS) site. LMS
and blended modules, relevant textbook chapters from also housed the subject guide, which included intended
Exercise Physiology: Theory and Application to Fitness learning outcomes for each topic, copies of the PowerPoint
and Performance (33), and lecturer-recorded video slides used in lectures, and a forum for discussion and ques-
duration tions. The lecture notes and forum were available to students
on the LMS 2 wk before semester beginning, and lecture
Topic Video Duration
recordings were made available shortly after the live lecture
Introduction to Exercise and Health 4 min 56 s concluded.
Bioenergetics (Chapter 3)
Overview 27 min 56 s
Overview of anaerobic and aerobic metabolism 4 min 23 s
Blended module (2014–2019).
Anaerobic metabolism 9 min 56 s Using a constructivist approach (34), we transformed the tra-
Aerobic metabolism 19 min 49 s ditional delivery into a contemporary curriculum comprised
Glucose and energy 8 min 52 s of a 5-wk blended theory module delivered over weeks 1–5
Lipids, protein, and energy 12 min 10 s during a 12-wk semester. With the curriculum redesign we
Sporting events and aerobic/anaerobic energy
contributions 3 min 6 s attempted to provide a more flexible curriculum for stu-
Exercise Metabolism (Chapters 4 and 13) dents, one that developed important skills (such as self-man-
Skeletal muscle fiber types 4 min 14 s agement) expected of science graduates to help prepare
Oxygen consumption and excess postexercise them to solve challenges of the twenty-first century and for
oxygen consumption (EPOC) 18 min 23 s
life-long learning.
Maximal oxygen consumption (V_ O2max) 9 min 4 s
Lactic acid 12 min 43 s The module incorporated a comprehensive range of ele-
Estimation of fuel use during exercise 2 min 57 s ments (see below) to support learning and give students flex-
Exercise intensity and fuel selection 10 min 16 s ibility and choice/autonomy regarding how and when they
Skeletal Muscle: Endurance Exercise Adaptations learn. The module was made available on the LMS before the
(Chapters 8 and 13)
Homeostasis, endurance training, and skeletal 10 min 30 s start of semester and introduced in the week 1 face-to-face in-
muscle fiber types in athletes troductory lecture (recorded and available for viewing on the
Endurance training-induced adaptations 18 min 10 s LMS). Students were told how the module worked, including
Significance and molecular basis of adaptations 7 min 32 s that workshop attendance, quiz completion, and forum posts
Thermoregulation (Chapter 12)
were not mandatory. The student guide, lecturer recordings,
Temperature homeostasis and heat loss during
exercise 13 min 59 s supplementary videos, quizzes, and forum were available to
Heat acclimatization 6 min 45 s students on the subject LMS site 2 wk before semester begin-
Circulatory Adaptations to Exercise (Chapter 9) ning, workshops were held in weeks 1–4, and the exam was
Cardiovascular control during exercise 5 min 9 s held in week 5.
Regulation of muscle blood flow during exercise 12 min 44 s
Comparison of trained and untrained individuals 6 min 52 s Student guide. A comprehensive guide was provided to
Double product 3 min 6 s students, which set out the module requirements, topics cov-
Arm versus leg and prolonged exercise 4 min 32 s ered and intended learning outcomes for each, suggested
Respiration and Exercise (Chapter 10) schedule for completing the module, available resources,
Respiratory control during submaximal exercise 3 min 34 s
Ventilatory responses to incremental exercise 10 min
assessment details, and copies of PowerPoint slides used in
Training-induced changes to the ventilatory lecturer-recorded videos.
response 1 min 24 s Lecturer-recorded videos. Recordings of narrated Pow-
Links Between Skeletal Muscle and Systemic erPoint slides were created by one of the authors (L.L.), an
Physiology (Chapter 13) 9 min 48 s experienced lecturer in exercise physiology, with Camtasia
(Camtasia Studio 8, Camtasia 9, and Camtasia 2018;
TechSmith, Okemos, MI) software. The videos incorporated
2010–2013 cohorts experienced traditional delivery via face-
images from the prescribed textbook. All 28 videos had the
to-face lectures, and students in 2014–2019 cohorts experi-
same PowerPoint template and style, to provide a sense of
enced the blended curriculum. To determine the impact of
the blended delivery on student learning, exam performance
was compared between groups as described below.
In 2019, 99 students were enrolled in the subject, with 95% Table 2. Details of exercise physiology questions in end-
enrolled in the Bachelor of Health Sciences and 5% in of-semester exam (2010–2013) and end-of-module exam
Biomedical Sciences, and were provided a questionnaire to (2014–2019)
assess their perceptions of the blended design as described Traditional Module Blended Module
below. 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019

Traditional module (2010–2013). Number of

From 2010 to 2013 we taught a traditional format human questions 11 23 20 20 22 30 36 50 50 50
exercise physiology theory module, over the first 4 wk of se- Type A
questions 7 11 10 10 11 10 16 30 30 30
mester in 12 face-to-face lectures of 50-min duration, with
Type K
learning assessed with an end-of-semester multiple-choice questions 4 12 10 10 11 20 20 20 20 20
exam (Table 2). The module was introduced to students in a Type A questions, stem and 5 options, 1 correct option. Type K
week 1 face-to-face introductory lecture, and all lectures were questions, stem and 4 options, 1 or more correct options. End-of-
recorded by Lectopia software and available for viewing on semester exam covered 3 theory topics, all with equal weighting.

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 BLENDED LEARNING SUPPORTS AUTONOMY AND IMPROVES PERFORMANCE
cohesion. Each video ended with a direction to an associated
formative and optional quiz (except for the first and last vid-
eos) and reference to the next video or topic. Students were
referred to supplementary videos at appropriate points
within the recordings. There was a total of 4 h and 20 min of
videos, and consistent with recommendations of Kaya (35)
and Mason and colleagues (36) all but one video were under
20 min, with an average length of 9.5 min (range 1.4 to 27.9
min).
Supplementary videos. Eighteen non-teacher-recorded
videos were available via links on the LMS site to supplement
the teacher-recorded videos. These videos were freely avail-
able through YouTube and included animations describing
physiological processes such as glycolysis and gas diffusion,
recordings of maximal oxygen consumption tests, and foot-
age of athletes competing in extreme temperatures. These
did not include links to videos or channels that provided in-
depth physiological explanations.
Quizzes. Twenty-six optional formative quizzes for im-
mediate feedback on learning were available on the LMS.
The questions were a range of multiple-choice, true/false,
and matching questions and were designed to test content
knowledge and its application. There was a total of 166 quiz
questions, with an average of 6.4 questions (range 1 to 19
questions) per quiz. Quiz answers were available once the
quiz was completed by an individual student. Students could
attempt each quiz an unlimited number of times, and
attempts were not time limited.
Workshops. One 2-h workshop was held per week for the
first 4 wk of the module. The workshops were designed to
consolidate learning of concepts delivered in the videos. No
new concepts were introduced, and no assessment was com-
pleted in the workshops. In the first hour multiple-choice
questions were discussed, with students answering ques-
tions anonymously via an audience-response system, and in
the second hour open-ended case study scenarios were dis-
cussed. Incorporating audience-response systems allows
instructors to gauge student understanding and identify
areas that are confusing or difficult for students (22, 37).
Questions covered in the workshop (but not answers) were
posted to the LMS after the workshops.
Exam. Student learning was assessed in an invigilated
multiple-choice exam held upon completion of the module,
in week 5 of the semester. Practice questions were provided
to students.
The formats of the exams between 2010 and 2019 are
explained in Table 2. Two types of multiple-choice questions
were used: type A and type K (38). Type A questions consist of
the stem and five options, one of which is correct or the best
answer. Type K questions consist of the stem and four options,
one or more of which is correct. Examinees are required to
respond using the following code: select A if options 1, 2, and 3,
are correct; B if 1 and 3 are correct; C if 2 and 4 are correct; D if
only 4 is correct; and E if all four options are correct.
Study Design and Data Analysis
We used a longitudinal time series design (39) to determine
the impact of the blended module on student learning. The
time series design involves a series of measurements at periodic
intervals, usually to measure the impact of a specific change
that occurs at some point during those measurements (39).
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We used a mixed-methods concurrent triangulation
design to determine student perceptions of the module and
student engagement. In this design, a researcher collects and
analyses quantitative (numeric) and qualitative (text) data
concurrently (40). The rationale for this approach is to
attempt to confirm, cross-validate, or corroborate findings
within a single study, resulting in well-validated and sub-
stantiated findings (40).
To address the aims of the study, a range of data sources
were analyzed. Student performance was determined from
exam marks (2010–2019). Student perceptions of the blended
model were determined from analysis of completed student
questionnaires by the 2019 cohort. Student engagement with
module resources by the 2019 cohort was determined from
the LMS access data. The study was conducted with approval
of the institution’s Human Research Ethics Committee (HEC
18/107). A waiver of consent was provided for retrospective
analysis of data.
Exam performance.
Student performance was determined by evaluating exam
marks. Performance on end-of-semester exams following
the traditional module (2010–2013) was compared to per-
formance on end-of-module exams following the blended
module (2014–2019) with independent t tests. v2 tests of
independence were used to examine the relationship
between module mode (traditional or blended) and exam
pass rates and the spread of grades.
Exam questions.
For determination of the level of difficulty, all exam questions
from 2010 to 2019 were mapped by two physiology academics
from another university (authors K.T., A.H.) against Bloom’s
taxonomy (41) levels (knowledge, comprehension, applica-
tion, analysis, synthesis, evaluation). Each academic mapped
individually and then met to discuss and reach consensus on
questions mapped to different Bloom’s levels. There was
mapper variability for 30% of the questions. For each exam,
the overall percent contribution from each Bloom’s level was
determined and comparisons made between groups (tradi-
tional vs. blended mode) with an independent t test.
Questionnaire.
At the end of the blended module in 2019, 99 students were
invited to complete a paper-based questionnaire comprised
of 29 questions, including 5-point Likert-scale and open-
ended questions (see Supplemental Material, available at
https://doi.org/10.26181/17134238). Three Likert scales were
used to assess students’ level of agreement (strongly dis-
agree, disagree, neutral, agree, strongly agree), ratings of
confidence (very low, low, medium/adequate, high, very
high), and ratings of importance (not at all important, not
too important, neutral, somewhat important, very impor-
tant). The questionnaire was administered after the end-of-
module exam, and students were assured that this was a vol-
untary activity, with no incentives offered, and had no bear-
ing on their marks. The questionnaire was completed by 67
students, which is a response rate of 68%. Descriptive statis-
tical analysis was conducted on the quantitative data, and
qualitative content analysis (42) was conducted on the
responses to the open-ended questions.
 BLENDED LEARNING SUPPORTS AUTONOMY AND IMPROVES PERFORMANCE

Student engagement. together the same significant difference (P = 0.05) would be

Student engagement with the student guide, lecturer-recorded
and supplementary videos, quizzes, and forums in 2019 were
determined through analysis of access statistics from the
LMS. The number of times they were accessed and date of
access were analyzed. Quiz attempts were collated with
more detailed analysis of data undertaken (number of
attempts, scores, and when students accessed the quizzes).
The number and nature of discussion posts to the module
forum on the LMS were also analyzed. The number of stu-
dents who attended each workshop was recorded.
Pearson’s product-moment correlation tests were used to
determine relationships between exam performance and
the number of times students accessed lecturer-recorded
and supplementary videos and total quiz attempts.
RESULTS
Exam Performance
Table 3 presents student performance data on the tradition-
ally taught end-of-semester module exam (2010–2013) and the
blended module end-of-module exam (2014–2019). Compared
with the traditional module, the exam mean mark was 12%
higher (P < 0.0001) and pass rates were 6.5% higher (P <
0.0001) in the blended module. The distribution of grades was
significantly different between the two modules (P < 0.01).
There was a shift in grades upward, with double the students
receiving A (>79.49%) grades in the blended module compared
with the traditional module (P < 0.0001), even though the
exam questions were more challenging (see below).
Exam Questions
observed, indicating that the blended module exam had a
higher percentage of questions higher up Bloom’s taxonomy.
Student Perceptions
Module format.
Students reported a preference for a combination of deliv-
ery modes for the theory content module, specifically, a
combination of online content delivery and face-to-face
workshops (83%), over fully online (14%) or fully face-to-
face (3%) teaching.
Qualitative content analysis found that students who pre-
ferred a combination of face-to-face and online delivery
appreciated the opportunity to ask questions in face-to-face
workshops and to learn at their own pace (Table 4). The stu-
dents who preferred online theory delivery appreciated the
opportunity to learn at their own pace, and students who
preferred face-to-face theory delivery liked the opportunity
for immediate feedback, and the scheduled face-to-face
classes helped them to manage their time.
Exam timing.
Students overwhelmingly preferred an in-semester exam
(86%) compared to an end-of-semester exam (9%), with the
remaining students reporting no preference (5%). Qualitative
content analysis of responses to the open-ended question
asking students to explain their preference for exam timing
found that students preferred in-semester exams because
they were less stressful, required less material to be learned,
and promoted learning (Table 5). Only two respondents had
no preference, and their responses did not explain their
preference.

Figure 1 presents the average percentage of exam questions
categorized as knowledge, comprehension, and application for
the end-of-semester exams (traditional format, 2010–2013)
and the end-of-module exams (blended format, 2014–2019).
There were no questions categorized as analysis, synthesis, or
evaluation. There were significantly more (P = 0.05) knowl-
edge questions in 2010–2013 (69.5%) compared with 2014–
2019 (59.9%). There were no significant differences between
traditional and blended formats for percentage of comprehen-
sion and application questions, although if these were grouped
Module curriculum scaffold.
Students were asked to rate the relative importance of each of
the elements of the curriculum scaffold for supporting their
learning (Fig. 2). Most students perceived that the student
notes, lecturer-recorded videos, and formative quizzes were
“very important” to their learning. Students most rated the
learning objectives, supplementary videos, and workshops as
“somewhat important.” Over half of students rated the LMS
forums as “not too important.” At least 10% of students rated
each element of the curriculum scaffold as “very important.”

Table 3. Student performance on traditional module (end of semester) and blended module (end of module) multi-
ple-choice exams
Traditional Module Blended Module
2010 2011 2012 2013 2010–2013 2014 2015 2016 2017 2018 2019 2014–2019
Enrollment 63 115 97 82 337 77 120 113 108 92 98 608
Mean mark 72.3 67.8 70.7 58.1 67.2 73.5 76.8 79.5 76.6 73.0 70.6 75.3
SD 16.5 14.8 13.4 15.0 15.6 14.8 15.2 15.1 13.5 13.5 17.0 15.2
Median mark 72.7 69.2 70.0 55.0 69.2 72.7 78.3 83.3 78.0 72.0 72.0 77.3
Minimum 18.2 23.1 40.0 30.0 18.2 36.4 30.0 30.6 34.0 44.0 26.0 26.0
Maximum 100.0 92.3 95.0 90.0 100.0 100.0 96.7 100 100.0 98.0 96.0 100.0
A (>79.49%), % 45.9 24.8 29.5 9.3 26.4 39.0 50.0 58.4 48.1 39.1 38.8 53.9
B (>69.49%), % 21.3 16.8 35.2 20.0 23.1 23.4 20.8 16.8 25.9 21.7 17.3 17.9
C (>59.49%), % 11.5 33.6 20.5 20.0 23.1 18.2 15.8 12.4 14.8 25.0 20.4 15.1
D (>49.49%), % 14.8 15.9 8.0 25.3 15.7 13.0 8.3 8.8 6.5 8.7 11.2 7.6
N (<49.90%), % 6.6 8.8 6.8 25.3 11.6 6.5 5.0 3.5 4.6 5.4 12.2 5.4
Pass rate, % 93.4 91.2 93.2 74.7 88.1 93.5 95.0 96.5 95.4 94.6 87.9 93.8
Significantly higher than 2010–2013 (P < 0.0001).

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 BLENDED LEARNING SUPPORTS AUTONOMY AND IMPROVES PERFORMANCE

80 before semester beginning (Fig. 4). Half of the cohort (51.5%)

*
2010-13
accessed the LMS before semester beginning.
70
2014-19
60
Student guide and learning objectives.
Average questions (%)

Most engagement with the student guide happened in week

50
40
30
20
10
0 Seventy-three percent of students accessed >90% of the vid-
Knowledge Comprehension
Question type
Figure 1. Comparison of average percentage of knowledge, comprehen-
sion, and application questions in the end-of-semester exam (traditional
format, 2010–2013) and end-of-module exam (blended format, 2014–
2019). The data are means þ SD. Significant difference, P = 0.05.
Most students (>80%) perceived that the topic learning
objectives were “always” or “usually” clear to them. Similarly,
most students (>80%) thought that the module exam was
“always” or “usually” clearly connected to the learning objec-
tives (Fig. 3).
As evident from Fig. 2, 70% of students viewed the work-
shops as “very important” or “somewhat important,” but
records of the number of students in attendance revealed
that not all students attended regularly. Qualitative content
analysis of responses to the open-ended question asking stu-
dents who did not attend to explain found that the main rea-
sons were that the workshop information was available
online, they had other commitments, and they did not need
the workshops (Table 6).
Student Engagement
We analyzed student engagement with a range of module
elements over the course of the 5-wk module, as well as 2 wk
1 of the semester (36.8%) followed by presemester (28.3%;
Fig. 4). There were students (15.2%) who did not access the
student guide on the LMS at all.
Lecturer-recorded videos.
Most students (85–99%) accessed the lecturer-recorded vid-
eos (Fig. 5). Thirty-seven percent of students accessed all 28
videos at least once, and one student accessed no videos.
Application
eos at least once.
Videos earlier in the module were accessed more than
those toward the end (Fig. 5).
Most engagement with the lecturer-recorded videos
occurred in week 5 (45.0%; Fig. 4), followed by weeks 1
(15.0%) and 2 (15.0%).
There was a weak, statistically significant (r = 0.37, P <
0.001) correlation between the number of times students
accessed the lecturer-recorded videos and their exam score
(Fig. 6), suggesting that their engagement level weakly con-
tributed to their performance.
Supplementary videos.
Fewer students accessed the supplementary videos (36–82%)
than the lecturer-recorded videos, with fewer students access-
ing supplementary videos for later topics (Fig. 5). Sixteen per-
cent (16.2%) of students accessed all 18 supplementary videos
at least once, and 8.1% of students accessed no supplementary
videos.
Most engagement with the supplementary videos occurred
in week 5 (33.4%; Fig. 4), followed by weeks 1 (17.9%) and 2
(16.2%).
There was a moderate, statistically significant (r = 0.46,
P < 0.001) correlation between the number of times stu-
dents accessed the supplementary videos and their exam

Table 4. Themes that emerged from student responses (49 students) to the open-ended question “What was the
main reason for your preference for content delivery mode?”
Students Who Preferred Combined Face-to-Face and Online Theory Delivery (39 respondents, 44 reasons)
Can ask questions in workshops (36.4%) Having face to face is helpful for revision and to ask any questions.
Able to get feedback from face-to-face workshop. Can get the answers for my queries immediately.
Can learn at own pace (15.9%) Allows you to work at your own pace.
I like to go at my own pace at home with the online content
Best of both worlds (13.6%) I like the way this subject was designed to have the online content and then clicker questions as a
workshop to check your knowledge and ask questions.
Good balance.
Fits into schedule better (13.6%) Good to have the videos so you can work it around life etc. & rewatch, pause, etc.
I liked watching lectures online as it made it easier for me to work & then study in my own time.
Students Who Preferred Online Theory Delivery (8 respondents, 11 reasons)
Can learn at own pace (54.5%) I can learn the content at my own pace.
Study, prepare at my pace.
More accessible (18.2%) Can access anywhere.
Can pause and replay recordings (18.2%) I find it useful to be able to rewatch videos and lectures & then write notes.
Students Who Preferred Face-to-Face Theory Delivery (2 respondents, 2 reasons)
Immediate feedback (50%) Question can be answered on the spot.
Time management (50%) I leave online until 2 days before assessment.
Students could list >1 reason. Exemplar quotes are provided for each theme. Percentage indicates frequency of comments on this
theme.

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Table 5. Themes that emerged from student responses (58 students) to the open-ended question “What was the
main reason for your preference of exam timing?”
Students Who Preferred In-Semester Exam (50 respondents, 78 reasons)
Less stressful (23.1%) Less stress at the end of semester
Places a lot of pressure at the end of semester–becomes overwhelming
Less content to learn (14.1%) Module exams allow me to focus on remembering and understanding smaller
chunks of knowledge.
Chance to learn & memories [sic] one particular topic at a time
Promotes learning (12.8%) Can learn and process sufficient information
Better opportunities to consolidate information
Students Who Preferred End-of-Semester Exam (6 respondents, 10 reasons)
Need more time to study (40%) Exams during the semester do not provide much time to revise.
The middle of the semester is very soon to learn and then be tested.
Clashes with other deadlines (30%) We had a lot of things due in week 5.
There are also a lot more assessments.
Students could list >1 reason. Exemplar quotes are provided for each theme. Percentage indicates frequency of comments on this
theme.

score (Fig. 7), suggesting that their engagement level mod-
erately contributed to their performance.
Quizzes.
Most (66–92%) students attempted the quizzes, with attempts
decreasing over the course of the module (Fig. 5). Forty-four
percent (44.4%) of students attempted all 26 quizzes at least
once, and 5.1% of students attempted no quizzes. Six students
had >80 quiz attempts, with one student having 134 quiz
attempts. Analysis of final scores on the formative quizzes
shows that 66% of quiz attempts resulted in a score of 100%.
Seven percent (7.1%) of students received a score of 100% for
all quizzes.
Most engagement with quizzes occurred in week 5 (61.2%),
followed by week 2 (11.4%; Fig. 4).
There was a weak, statistically significant (r = 0.21, P = 0.04)
correlation between the number of times students attempted
quizzes and their exam score (Fig. 8), suggesting that their
level of engagement with quizzes weakly contributed to their
performance.
Workshops.
Workshop attendance declined over the 4 wk: 90, 31, 24, and
11 students attended in weeks 1, 2, 3, and 4, respectively.
Discussion forum.
There was a total of six forum threads and 13 posts made,
seven by students and six by staff. Five of the threads
were initiated by students, and the nature of the posts
were physiology questions (2 posts), request for addi-
tional resources (2 posts), staff announcements (1 post),
and technical issues (1 post). The forum was viewed 239
times by 45.5% of students.
Student Performance
Student exam performance was significantly higher with
the blended module compared with traditional delivery via
face-to-face lectures. Similarly, McFarlin (22) reported a sig-
nificant increase in students’ exercise physiology grades
when studying in blended format compared with tradi-
tional delivery. Our findings are further supported by a
meta-analysis that found that blended learning better facil-
itates student learning, compared with traditional delivery,
in STEM disciplines (43). Analysis of the exam questions in
the present study revealed a significantly higher proportion
of questions in the traditional module exams that assessed
knowledge, the lowest Bloom’s level, indicating that the
exams for the traditional module were somewhat easier
than the exams for blended delivery. Therefore, the nature
of the assessment questions cannot explain the improve-
ment in student performance. In the present study, stu-
dents overwhelmingly preferred an exam taken upon
completion of the module (as in our model) that assesses
only that module’s content over a final exam completed at
the end of semester. Students who preferred module exams
reported experiencing less stress and thought module
exams were better for learning. A negative correlation has
been observed between anxiety and academic achieve-
ment, that is, low anxiety appears to be related to high
grades and vice versa (44). Students with high anxiety find
studying difficult, have impaired thought processes and
problem-solving, spend less time on tasks, and are more
easily distracted than students with low anxiety (44).
Therefore, holding the exam during the semester rather
than at the end may contribute to improved student per-
formance through reduction in stress.

DISCUSSION Our Model—Student Perceptions

In this report we show how a traditional exercise physiol-
ogy theory module was transformed into a blended module
that included multiple elements to promote students’
autonomy over their learning. Implementation of the blended
module improved student learning, as determined by an
improvement in student grades in an exam with a higher pro-
portion of higher-order questions, a high level of student
engagement with online resources, and an overall positive
student experience.
In the present study, students preferred the delivery mode
we implemented, that is, theory delivered in video form and
workshops held face to face, over traditional face-to-face
delivery of theory and workshops. Similarly, Shang and Liu
(45) found that 68% of students saw blended learning as a
better learning model than face-to-face lectures or fully
online study, and Fisher and colleagues (46) found that
blended learning contributed to perceptions of student satis-
faction and engagement. Consistent with findings of other

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 BLENDED LEARNING SUPPORTS AUTONOMY AND IMPROVES PERFORMANCE

Learning objectives

Student notes

Lecturer-recorded videos

Supplementary videos
Figue 2. Student ratings of importance of
elements of the curriculum.
Quizzes

Workshops

Forums

0 10 20 30 40 50 60 70 80 90 100

Not at all important Not too important Somewhat important Very important

studies, students in the present study who preferred online
theory delivery appreciated learning at their own pace (17,
22, 45–47) and the independence and control (48) this mode
allows. Students preferred face-to-face workshops because
they provided an opportunity to ask questions. This is con-
sistent with Boelens and colleagues’ (10) identification of
workshops as an instructional activity important for adjust-
ing the learning process through provision of feedback and
clarification (see below for further discussion of workshops).
A minority of students preferred face-to-face theory delivery
because they felt that regular, timetabled classes better scaf-
folded their learning. This is consistent with the findings of
Rasheed and colleagues (32), who found that self-regulation
is one of the bigger challenges facing students learning in
blended mode, with students struggling to organize and
manage their studies independent of their instructor.
Blended learning provides students with freedom to learn at
their own pace and more flexibly, but the risk is that this
freedom can result in students adopting poor self-regulation
behavior (32). Our model could be improved by incorpora-
tion of activities and discussions that discuss self-regulation
behavior and stimulate students to focus on improving these
skills (32). This has benefits beyond greater success with a
blended module, as self-regulation is an essential skill for
STEM graduates (45, 49).
Results indicate that all aspects of our model were deemed
very important by segments of the student cohort. This find-
ing is consistent with those of Scagnoli and colleagues (48)
and Shang and Liu (45), who found that undergraduate stu-
dents found that a range of instructional activities, including
quizzes, video lectures, and interactive activities, influenced
their learning in online and blended subjects. We believed
that inclusion of a range of elements would result in a model
that catered for a student population with diverse learning
styles and preferences (48). That students did not rate all ele-
ments of the module as being important or did not engage
with each was not cause for concern. It is possible that our
approach did not fully model and guide students into effec-
tively using the full range of module elements to engage
actively or highlight the way past students had used the ele-
ments successfully (50). The natural outcome of purpose-
fully designing a module that has optional support elements
attractive to a diverse cohort is that students exercise their
autonomy and make use of the resources that they feel are of
benefit to their learning and disregard others. Shifting to-
ward more flexible blended models may require academics
to reconceptualize their notions of their role in student
learning and what student engagement looks like.
Our Model—Instructional Activities to Assist Regulation
of Learning
Our blended learning model was designed to provide stu-
dents with more flexibility and autonomy than was possible
with the previous traditionally delivered model. More student
autonomy means that students’ ability to self-regulate their
learning becomes essential for success (10). Vermunt and
Verloop (51) developed a framework of instructional activities
to assist students in regulating their learning, with activities
falling into four categories: orienting and planning, monitor-
ing, adjusting, and evaluating. Below we discuss the elements
of our model with reference to this framework. Our model
incorporated instructional activities from each category,
which we believe contributed to its success in terms of stu-
dent learning and perceptions.

Learning objectives are clear to me

Figure 3. Student ratings of the clarity of

The module exam was clearly connected to the
the learning objectives and their degree learning objectives
of assessment in the exam.
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Never Rarely Sometimes Usually Always

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 BLENDED LEARNING SUPPORTS AUTONOMY AND IMPROVES PERFORMANCE

Table 6. Themes that emerged from student feedback
regarding the reasons for not attending workshops
Workshop Information/Resources Were Available Online (21.6%)
Content was online.
Clicker sessions were online.
Other Commitments (21.6%)
Focusing on other assessments
Work commitments
Class clashes
Workshops Not Needed (13.5%)
Full understanding of topic
Info was included on the videos.
Exemplar quotes are provided for each theme. Percentage indi-
cates frequency of comments on this theme. Thirty-one students
responded, and 37 total reasons were provided.
Introductory lecture and student guide.
Through the face-to-face introductory lecture in the first
week of the module and provision of a comprehensive stu-
dent guide, our model incorporates two of the four instruc-
tional activities relating to the orientation and planning
phase identified by Boelens and colleagues (10) in their
review, communicating organizational information and
communicating expectations. The lecture provided stu-
dents with an overview of the structure of the module,
topics to be covered, resources available, timing of work-
shops and assessment, and expectations of students; such
a session is commonly used in blended modules (10).
Consistent with other blended modules (52), our student
guide included this introductory and summary informa-
tion in written format and included learning objectives, a
suggested weekly schedule for navigating the module, and
printouts of the PowerPoint lecture notes. You (53) found a
weak but statistically significant relation between reading
the student guide at the beginning of a subject and subject
achievement. Reading the guide provided students with
knowledge of important events in advance, which allows
them to regulate their studies and participate in learning
activities. We did not include instructional activities to mea-
sure prior knowledge or familiarize learners with technology,
although these could be incorporated in the future. The
module in its 2019 format made use of technology that stu-
dents in our cohort had extensive experience with before our
module, that is, the LMS, YouTube, and an audience-
response system. Familiarization could benefit students in
earlier year levels or could be developed and added to the
scaffold as a refresher.
Lecturer-recorded and supplementary videos.
Students perceived that the lecturer-recorded videos were
the equal most important elements of the module along with
formative quizzes. Most students accessed the lecturer-
recorded videos, with most engagement in weeks 1, 2, and 5
(exam week) of the module. Past research has found that stu-
dents were highly satisfied with video lectures (48, 54–56)
and perceived that videos enhance their engagement and
provide additional learning opportunities while increasing
motivation (57). The presence of the instructor, via video
and/or audio, has consistently been found to be important
for perceived learning and satisfaction (58). Students feel a
teaching and social presence through lecturer-recorded vid-
eos, and feeling a connection with the instructor increases
their engagement (59) and learning (60). Scagnoli and col-
leagues (48) found that graduate students had a slightly
higher perception of learning impact of video lectures than
undergraduates, suggesting that differences may exist based
on education level and our findings may not be replicated in,

Pre-semester Week 1 Week 2 Week 3 Week 4 Week 5

800

700
Access/attemt number

600

500
Workshop 1

Workshop 2

Workshop 3

Workshop 4

400

300

200
Exam

100

0
01-Apr-19
02-Apr-19
03-Apr-19
04-Apr-19
05-Apr-19
18-Feb-19
19-Feb-19
20-Feb-19
21-Feb-19
22-Feb-19
23-Feb-19
24-Feb-19
25-Feb-19
26-Feb-19
27-Feb-19
28-Feb-19
01-Mar-19
02-Mar-19
03-Mar-19
04-Mar-19
05-Mar-19
06-Mar-19
07-Mar-19
08-Mar-19
09-Mar-19
10-Mar-19
11-Mar-19
12-Mar-19
13-Mar-19
14-Mar-19
15-Mar-19
16-Mar-19
17-Mar-19
18-Mar-19
19-Mar-19
20-Mar-19
21-Mar-19
22-Mar-19
23-Mar-19
24-Mar-19
25-Mar-19
26-Mar-19
27-Mar-19
28-Mar-19
29-Mar-19
30-Mar-19
31-Mar-19

Guides L-R Video accesses Supp video accesses Quiz attempts Forums

Figure 4. Engagement with module elements over 7 wk of the blended module. Gray lines indicate start of weeks starting on Monday; gray shading indi-
cates workshop day (weeks 1–4) or exam (week 5).

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 BLENDED LEARNING SUPPORTS AUTONOMY AND IMPROVES PERFORMANCE

100

Videos accessed/quizzes attempted (% students)

90

80

70

60

50

Figure 5. Percentage of students who accessed videos and 40

attempted quizzes over the course of the module.
30

20

10

0
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28
Video/quiz number

Lecturer-recorded videos Quizzes Supplementary videos

for example, first-year university students. Not all students repeat information or contain information they could read in
in the present study appear to have accessed all lecturer- a textbook. For some students in the present study, the sup-
recorded videos. A positive relation has been observed plementary videos may have provided a refresher on a topic
between satisfaction with video lectures and the number of (e.g., mechanics of breathing) or a further illustration of a
videos viewed (48), and it is possible that students in the point (e.g., a recording of an athlete experiencing heat exhaus-
present study who were not satisfied with video lectures (i.e., tion), whereas others who remembered the background or
the minority who reported a preference for face-to-face understood the point while watching the lecturer-recorded
theory delivery) may have watched fewer videos. video may have seen these as repetitive and made the practi-
The supplementary videos were valued by some students cal choice to not engage with them (48).
who appear to have appreciated the animations, background,
and additional examples provided, and engagement with Quizzes.
these videos did significantly correlate with performance. The inclusion of optional, online formative quizzes that
Scagnoli and colleagues (48) found that students valued vid- accompanied teacher-recorded videos supports both the moni-
eos that introduced and reinforced knowledge and connected toring phase, through formative teacher assessment, and the
with class content and activities but not those thought to adjusting phase, through provision of feedback (10). Quizzes

100 100

90 90

80 80

70 70
Exam score (%)
Exam score (%)

60 60

50 50

40 40

30 30

20 20

10 10

0 0
0 20 40 60 80 100 120 140 0 5 10 15 20 25 30 35 40
Number of times lecturer-recorded videos accessed Number of times supplementary videos accessed

Figure 6. Weak correlation between number of times students accessed Figure 7. Moderate correlation between number of times students
lecturer-recorded videos and their exam score. Statistically significant, r = accessed supplementary videos and their exam score. Statistically signifi-
0.37, P < 0.001. cant, r = 0.46, P < 0.001.

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 BLENDED LEARNING SUPPORTS AUTONOMY AND IMPROVES PERFORMANCE
100
90
80
70
Exam score (%)
60
50
40
30
20
10
0 face to face or online would enhance the flexibility and may
0 20 40 60 80 100 120
Number quiz attempts
Figure 8. Weak correlation between number of times students attempted
quizzes and their exam score. Statistically significant, r = 0.21, P = 0.04.
are commonly included in blended modules (e.g., Refs. 45, 61,
62). The self-assessment quizzes were one of the top-rated ele-
ments of the module, and we observed a high level of engage-
ment with quizzes by students. Quizzes are an element of
blended learning models that are used to motivate students;
they enhance motivation through increased autonomy, that is,
they provide more responsibility to learners (10). Unlike in
some blended models (e.g., Refs. 45, 63), students were not
required to complete our quizzes and they did not contribute
to their final mark. Voluntary engagement with nonmandatory
learning activities is an effective indicator of a self-regulated
learner (64). Although students reported the quizzes to be a
very important element of the module, not all students
engaged with the quizzes, and there was only a weak, albeit sig-
nificant, correlation of quiz completion and their final grade.
Consistent with Jones and Korula (65), we found that engage-
ment with the quizzes decreased steadily over the course of the
module. Our quizzes only provided correct answers, without
feedback statements explaining correct and incorrect answers.
Inclusion of this additional feedback may be beneficial in help-
ing students to identify the deficits in their knowledge and
may encourage greater use by students (66).
Workshops.
The weekly face-to-face workshops were the main place
where students asked questions of the instructors and sought
feedback or clarifications. An audience-response system was
used to gauge student learning and identify areas students
were struggling with, which allowed the instructor to decide
which topics to devote time to explaining (22, 37). However,
workshops were not perceived as important by many stu-
dents, and only a small percentage of students attended work-
shops, with attendees declining in number over the course of
the module. Kauffman and colleagues (61) found that stu-
dents who attended the workshops in their cohort had lower
self-efficacy and effort regulation, which reflects that they
were weaker at self-management and maintaining effort in
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the face of distraction. Workshop attenders also had stronger
preferences for collaboration and dialogue with peers (61).
Consistent with Kauffman and colleagues’ (61) model, in our
model students could obtain all module content and perform
well on knowledge-based assessments without attending
face-to-face workshops, evidenced by the high mean exam
scores and pass rates despite low workshop attendance fig-
ures. We did not expect that students had to attend to suc-
ceed, and one of the reasons students gave for not attending
was that they did not need to. The workshops were designed
to cater to students who required the reassurance of face-to-
face engagement. We succeeded in creating an opportunity
for this cohort of students (20%), so it is worthwhile to keep
this as part of the module design. During the COVID-19 pan-
demic, workshops were held online and provided students
with the added option of asking/answering questions with the
chat function. Investigation of the possibilities of hybrid
workshops where students can attend the same classes either
140
appeal to more students.
Discussion forums.
Our model used online discussion forums to support both
the monitoring phase of learning, through organizing peer
assessment, and the adjustment phase, through the provi-
sion of feedback and clarifications (10). Consistent with the
findings of other studies (45, 67), students in the present
study made little use of discussion forums and only 28%
rated the forums as somewhat or very important. Casotti and
colleagues (68) found that discussion forums were one of the
most important elements of their model; however, in con-
trast to the present study, they required students to post to
the forums and to respond to posts of others. The lack of
posts to the forums may be because students are reluctant to
post questions publicly (32) or because students feel they
must write out their questions and do so carefully (69).
Forums have been found to be valuable for students who do
not post but view the forum discussions (69). This is consist-
ent with the findings of the present study, in which almost
half of the students viewed the forums but only 13 posts were
made. There may be other ways to provide students with
opportunities to ask questions asynchronously or for using
forums for higher-order detailing of explanations (32), partic-
ularly for students who appreciate engaging with instructors
online.
Exam.
Like most studies reviewed by Boelens and colleagues (10)
that included a final examination, we held this assessment
during a face-to-face session. Unlike most of these studies,
the final examination was the only assessment for the mod-
ule; in other models, students received marks for the exami-
nation as well as for online formative quizzes, contribution
to forum discussions, and papers (10).
Student Engagement with LMS
Student engagement with resources on LMS aligned with
student feedback on elements of the model that were most
important for their learning. This is consistent with findings
of Murray and colleagues (70) that students report a tend-
ency to only access resources they believe necessary to
385
 BLENDED LEARNING SUPPORTS AUTONOMY AND IMPROVES PERFORMANCE
complete assessment tasks, mainly because of time con-
straints. Lecturer-recorded videos and quizzes were accessed
most in weeks 1, 2, and 5 of the module, suggesting that stu-
dents strongly engaged with the module early and again in
the final week in preparation for the exam. Mogus and col-
leagues (67) found a positive correlation between student
access to LMS activities (e.g., assignments, forums, resour-
ces) and their final mark and concluded that student learn-
ing outcomes and learning effectiveness are influenced by
engagement with the online space.
The data were also analyzed to gain an understanding of
how students use the resources for learning when they are
given more autonomy. Below, we discuss some observations
that may be important to consider when designing blended
modules.
Timing of resource availability.
In the present study, all module materials were available on
the LMS 2 wk before the module started. Some have also
made all resources available before the module starting (68),
whereas others released materials sequentially during the se-
mester (3, 45). Making all materials available before the mod-
ule starts allows students to access information and resources
early and to progress at a faster pace if they wish to do so (68).
LMS access data showed that half of the students in the pres-
ent study made use of the early availability of resources and
accessed student guides and lecturer-recorded videos and
attempted quizzes before the semester started. Early access of
resources may be related to students’ prior knowledge of the
subject matter, which influences their perceived “need” to
access the resources (71). This requires high levels of organiza-
tion by the instructors, but the benefit is that once the module
starts efforts can be focused on discussions with students and
not development of materials (68).
Access to resources and performance.
We found weak to moderate positive correlations between
access to lecturer-recorded and supplementary videos and
quiz attempts and exam performance, suggesting that each
contributed in a small way to the exam score. Murray and col-
leagues (70) found that high access rates to the entire suite of
their resources were moderately correlated with high grades.
Studies have found that analytic data can explain individual
differences in online learning (72) and that active participation
in online courses through the LMS is significantly related to
academic performance (72–75). The present study was not
designed to specifically investigate what data analytics can tell
us about student learning styles or the relation with academic
performance; this is a possible avenue for future research.
Limitations
Our study focuses on an exercise physiology module for
health and biomedical science students; the results may
not be generalizable to other disciplines. LMS analytics
data only indicate that students have accessed items such
as lecturer-recorded and supplementary videos, forums,
and student guides, and we do not know how long they
spent engaging with the resources (if at all). Therefore, the
significance of the data is limited to confirming student
perception data and providing an overview of student
engagement with resources in our model. We do not have
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comparable student experience and engagement data
from students who completed the traditional face-to-face
module; however, student comments on course evalua-
tions during this period indicated that the students were
satisfied. We do not conclude that students had a more
positive experience of the module in blended compared to
traditional mode.
Recommendations/Future Directions
In 2020, in response to the COVID-19 pandemic, this mod-
ule was taught fully online for the first time, with the face-to-
face workshops replaced with synchronous online work-
shops held via Zoom and an online exam. These workshops
were well attended, and we will consider incorporating these
sessions in future iterations of this module.
Although our model provides more flexibility than the tra-
ditional model of face-to-face scheduled theory delivery via
lectures and workshops, there is scope to increase the
amount of choice students can exercise in their learning.
Boelens and colleagues’ review (10) found that in most
blended learning models the instructors determined the pro-
portion of online and face-to-face activities and what was
delivered in these modes, limiting student control to time-
and place-independent activities. How blended learning
models can be designed to enhance student control is an
area for future investigation.
In addition, assessment should include questions that
assess the higher-order Bloom’s levels, including analysis,
synthesis, and evaluation, to challenge and differentiate
between the higher-achieving students but also build skills
required for work readiness (76).
Conclusions
The COVID-19 pandemic has forced a rethink of how we
approach many areas of our lives, including the provision of
higher education. Discussions of what delivery modes work
best to support student learning have been ongoing for deca-
des, and the remote learning approaches rapidly adopted
during the pandemic may have shifted some long-held per-
ceptions among academic staff and students. We have pre-
sented an example of a blended model that has an emphasis
on learner autonomy and flexibility and resulted in
improved student learning compared with a fully face-to-
face module. Students positively perceived the format of the
module, with segments of the cohort finding all elements of
the model to be important. Student perception data were
consistent with basic data analytics. The pace at which the
landscape of higher education is changing has increased as
we enter the third decade of this century. At a time when
competition for students among higher education institu-
tions intensifies, the degree to which institutions provide
students with flexibility and supportive learning environ-
ments may impact their enrollments. Educators from a
range of science disciplines are encouraged not only to trial
the model presented in this report but also to build on this
work, by embedding additional flexibility, such as providing
a fully online option that includes synchronous and interac-
tive workshops. How much longer will it be before the sector
embraces the way of the future, and we can say “ding-dong,
the traditional lecture is dead”?
 BLENDED LEARNING SUPPORTS AUTONOMY AND IMPROVES PERFORMANCE
SUPPLEMENTAL INFORMATION
Supplemental Material: https://doi.org/10.26181/17134238.
DISCLOSURES
No conflicts of interest, financial or otherwise, are declared by
the authors.
AUTHOR CONTRIBUTIONS
B.L.J. and L.L. conceived and designed research; B.L.J., K.T.,
and A.H. analyzed data; B.L.J., K.T., A.H., and L.L. interpreted
results of experiments; B.L.J. prepared figures; B.L.J. and L.L.
drafted manuscript; B.L.J., K.T., A.H., and L.L. edited and revised
manuscript; B.L.J., K.T., A.H., and L.L. approved final version of
manuscript.
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