Document Type : Original Article

Authors

1 Department of Psychiatric Nursing, School of Nursing, Khoy University of Medical Sciences, Khoy, Iran

2 Department of Pediatric Nursing, School of Nursing, Khoy University of Medical Sciences, Khoy, Iran

Abstract

INTRODUCTION: With the unintended closure of classrooms following the outbreak of COVID‑19, the 
virtual education method is used as an alternative to face‑to‑face education. Virtual education is one 
of the important factors in promoting the learning of medical students and has many benefits such as 
increasing the ability of critical thinking, problem‑solving skills, and self‑directed learning. However, 
critically examining students’ perceptions of e‑learning can help improve quality and better planning.
MATERIALS AND METHODS: This research was a qualitative study. Twelve students were enrolled 
in the study based on purposive sampling. Data were collected using in‑depth semi‑structured 
interviews in 2020. All interviews were recorded and then transcribed and analyzed using a continuous 
comparison and conventional content analysis approach.
RESULTS: Data analysis revealed four main themes and ten subthemes. The main themes included 
“student concern,” “teacher barriers,” “technology weakness,” and “asynchronous virtual learning 
flexibility.”
CONCLUSION: Asynchronous e‑learning in the COVID‑19 outbreak had its advantages and 
disadvantages. By analyzing students’ perceptions in this field, some better designs and planning 
can be done to increase the quality of education.

Keywords

1. Sindiani AM, Obeidat N, Alshdaifat E, Elsalem L, Alwani MM, 
Rawashdeh H, et al. Distance education during the COVID‑19 
outbreak: A cross‑sectional study among medical students in 
North of Jordan. Ann Med Surg (Lond) 2020; 59:186‑94.
2. Ibrahim NK, Al‑Raddadi R, AlDarmasi M, Al Ghamdi A, 
Gaddoury M, Al‑Bar H, et al. Medical students’ acceptance and 
perceptions of e‑learning during the COVID‑19 closure time 
in King Abdulaziz University, Jeddah. J Infect Public Health 
2021:149(1)17‑23.
3. Gaur U, Majumder MA, Sa B, Sarkar S, Williams A, Singh K. 
Challenges and opportunities of preclinical medical 
education: COVID‑19 crisis and beyond. SN Compr Clin Med 
2020 2:1992–1997.
4. O’Doherty D, Dromey M, Lougheed J, Hannigan A, Last J, 
McGrath D. Barriers and solutions to online learning in medical 
education – An integrative review. BMC Med Educ 2018; 18:130.
5. Warnecke E, Pearson S. Medical students’ perceptions of using 
e‑learning to enhance the acquisition of consulting skills. 
Australas Med J 2011; 4:300‑7.
6. Vallée A, Blacher J, Cariou A, Sorbets E. Blended learning 
compared to traditional learning in medical education: Systematic 
review and meta‑analysis. J Med Internet Res 2020; 22:e16504.
7. Khasawneh AI, Humeidan AA, Alsulaiman JW, Bloukh S, 
Ramadan M, Al‑Shatanawi TN, et al. Medical students and 
COVID‑19: Knowledge, attitudes, and precautionary measures. 
A descriptive study from Jordan. Front Public Health 2020; 8:253.
8. Vitoria L, Mislinawati M, Nurmasyitah N. Students’ perceptions 
on the implementation of e‑learning: Helpful or unhelpful. 
J Physics 2018;1088(1)258.
9. Al‑Balas M, Al‑Balas HI, Jaber HM, Obeidat K, Al‑Balas H, 
Aborajooh EA, et al. Distance learning in clinical medical 
education amid COVID‑19 pandemic in Jordan: Current situation, 
challenges, and perspectives. BMC Med Educ 2020; 20:1‑7.
10. Abbasi S, Ayoob T, Malik A, Memon SI. Perceptions of students regarding E‑learning during COVID‑19 at a private medical 
college. Pak J Med Sci 2020; 36:S57‑61.
11. Lyndon MP, Henning MA, Alyami H, Krishna S, Zeng I, 
Yu TC, et al. Burnout, quality of life, motivation, and academic 
achievement among medical students: A person‑oriented 
approach. Perspect Med Educ 2017; 6:108‑14.
12. Speziale HS, Streubert HJ, Carpenter DR. Qualitative Research in 
Nursing: Advancing the Humanistic Imperative wolters Kluwer: 
Lippincott Williams and Wilkins; 2011.
13. Graneheim UH, Lindgren BM, Lundman B. Methodological 
challenges in qualitative content analysis: A discussion paper. 
Nurse Educ Today 2017; 56:29‑34.
14. Elo S, Kääriäinen M, Kanste O, Pölkki T, Utriainen K, Kyngäs H. 
Qualitative content analysis: A focus on trustworthiness.
15. AlAteeq DA, Aljhani S, AlEesa D. Perceived stress among students 
in virtual classrooms during the COVID‑19 outbreak in KSA. 
J Taibah Univ Med Sci 2020; 15:398‑403.
16. Kebritchi M, Lipschuetz A, Santiague L. Issues and challenges 
for teaching successful online courses in higher education: 
A literature review. J Educ Techno Syst 2017; 46:4‑29.
17. Thapa P, Bhandari SL, Pathak S. Nursing students’ attitude on the 
practice of e‑learning: A cross‑sectional survey amid COVID‑19 
in Nepal. PLoS One 2021; 16:e0253651.
18. Hartshorne R, Heafner TL, Petty TM. Teacher Education 
Programs and Online Learning Tools: Innovations in Teacher. 
2013 Published in the United States of America by Information 
Science Reference (an imprint of IGI Global).
19. Shafiei Sarvestani M, Mohammadi M, Afshin J, Raeisy L. Students’ 
experiences of e‑learning challenges; a phenomenological study. 
Interdiscipl J Virtual Learn Med Sci 2019; 10:1‑10.
20. Keshavarzi MH, Soltani Arabshahi SK, Gharrahee B, Sohrabi Z, 
Mardani‑Hamooleh M. Exploration of faculty members’ 
perceptions about virtual education challenges in medical 
sciences: A qualitative study. J Adv Med Educ Prof 2019; 7:27‑34.
21. Sahu P. Closure of universities due to coronavirus disease 
2019 (COVID‑19): Impact on education and mental health of 
students and academic staff. Cureus 2020; 12:e7541.
22. Kaur N, Dwivedi D, Arora J, Gandhi A. Study of the effectiveness 
of e‑learning to conventional teaching in medical undergraduates 
amid COVID‑19 pandemic. Natl J Physiol Pharm Pharmacol 
2020;10: (7): 511‑518.
23. Kohan N, Soltani Arabshahi K, Mojtahedzadeh R, Abbaszadeh A, 
Rakhshani T, Emami A. Self‑ directed learning barriers in a virtual 
environment: A qualitative study. J Adv Med Educ Prof 2017; 
5:116‑23.
24. Wilcha RJ. Effectiveness of virtual medical teaching during 
the COVID‑19 crisis: Systematic review. JMIR Med Educ 2020; 
6:e20963.
25. Konrady DM. Choosing to Participate in E‑Learning Education: 
A Study of Undergraduate Students’ Diverse Perceptions, 
Attitudes, and Self‑Identified Barriers To E‑Learning ProQuest 
Dissertations Publishing, Drexel University; 2015.
26. Ghanizadeh A, Mosallaei S, Dorche MS, Sahraian A, 
Yazdanshenas P. Attitude and use of E‑learning, education by 
medical students in Shiraz, Iran. Intern Med Med Invest J 2018; 
3:108‑11.
27. Lew EK, Nordquist EK. Asynchronous learning: Student 
utilization out of sync with their preference. Med Educ Online 
2016; 21:30587.
28. McCutcheon K, O’Halloran P, Lohan M. Online learning versus 
blended learning of clinical supervisee skills with pre‑registration 
nursing students: A randomised controlled trial. Int J Nurs Stud. 
2018;82:30‑9.
29. Geraghty JR, Young AN, Berkel TD, Wallbruch E, Mann J, ParkYS,
et al. Empowering medical students as agents of curricular change: 
A value‑added approach to student engagement in medical 
education. Perspect Med Educ 2020; 9:60‑5.
30. Pei L, Wu H. Does online learning work better than offline learning 
in undergraduate medical education? A systematic review and 
meta‑analysis. Med Educ Online 2019; 24(1)e 1666538.
31. Doddaiah SK, Kulkarni P, Mohandas A, Murthy MR. Learning 
with lockdown: Utility of whatsApp status‑based multiple‑choice 
question discussion on COVID‑19 among medical students and 
teaching faculty. J Educ Health Promot 2021; 10:168.