EARNING CHALLENGES FOR NURSES WITH E-LEARNING COURSES

OLEH:

ANITA M. HUTAURUK

225212013

PRODI KEPERAWATAN

PASCASARJANA INSTITUT ILMU KESEHATAN STRADA INDONESIA

2024
 LEARNING CHALLENGES FOR NURSES WITH E-LEARNING COURSES

INTRODUCTION

Nowadays, the use of information technology (IT) in education is

unquestionable. The increasing advancement of IT has changed the scenario of
education. With the advent of the current COVID-19 situation, it has undoubtedly
provided a solution to most of our educational needs when all educational institutions
remain closed due to the pandemic.

The current emergency due to the COVID-19 pandemic has led to an urgent change
in the education of nursing students from traditional learning to distance learning...

The global spread of coronavirus disease 2019 (COVID-19) triggered a

variety of public health responses. School and university closures are some of the
most widely practiced social (physical) distancing measures to slow the spread of this
infectious disease. Many countries in Asia and Europe have instituted nationwide
school closures, while some school districts and states in the United States have also
closed schools.

The COVID-19 pandemic has significantly disrupted every aspect of human

life including the education system. It causes chaos that forces educational
institutions to stop their regular activities [1]. School and university closures
impacted more than 1.5 billion students and youth worldwide [2]. In Nepal, the
pandemic resulted in the closure of all educational institutions for almost nine months
[3]. Many schools and universities started to shift from traditional classroom teaching
to virtual education methods to overcome the educational losses due to the lockdown.
Tribhuvan University (TU), one of the renowned and leading universities in Nepal,
was officially allowed to start online classes along with guidelines and the Ministry
of Education also appealed to stakeholders to start classes using alternative methods
[4]. Information and communication technology (ICT) has revolutionized e-learning.
E-learning has the advantage of lectures that can be
 It is accessible anywhere and anytime and can be revised many times.
However, drawbacks include limited feedback from students, the need for self-
motivation, dependence on internet availability and expensive digital gadgets,
difficulties in the transfer of psychomotor and affective skills, and health hazards
associated with prolonged gadget use (Cook, 2007).

DISCUSSION

The shift to online teaching methods has become a necessity, no longer an

option. However, the extent to which countries are prepared to meet this challenge is
something that has yet to be audited. With the second wave of the pandemic hitting
hard and with the reintroduction of lockdowns, especially in economically challenged
countries, where there is a dearth of easy access to technology and e-learning
opportunities, a new challenge arises: the need to provide continuing education and
training for nursing and medical students. Some countries are wondering if e-learning
will become the norm after the pandemic.

However, the pandemic has not only affected the health sector. Most nursing
activities are also affected. In Spain, as well as in other countries, the presence of
nursing students in health care centers has been suspended [5]. It has been observed
how, with great speed, schools and universities have been closed in the world,
affecting more than 1.570 million students in 191 countries [8]. It is important to
decide how to continue the education of future nurses, and various educational
solutions have been implemented, all of which are based on distance learning.
Professors, who are experts in the subject and have knowledge of traditional
classroom didactics, have found themselves forced to deal with e-learning overnight,
although not all of them are prepared. The same is true for students, who have had to
change from a model based on obligation and face-to-face learning, to one where
students have to freely and voluntarily engage in their learning [9]. All this in
addition to finding themselves in a context of expectation and uncertainty.

The significance and efficacy of e-learning implementation has been

scrutinized by previous studies. They reported several reasons for its overall
acceptance including ease of use, flexibility, and better control of the environment.
However, despite its benefits, there are some limitations in e-learning such as social
isolation, lack of interaction between teachers and students, technical and
connectivity issues [5]. In a study conducted in Iraq, lack of technical support was
identified as one of the barriers to e-learning [6].

the widening pandemic and the need for continued education, educational
institutions have shifted rapidly to distance and online learning. While public health
officials largely agree that the general threat of COVID-19 is best combated with
social distancing measures, specific measures to implement emergency e-Learning
protocols do not change the pandemic itself, but only indirectly by limiting face-to-
face interactions in the classroom. [5

E-learning tools play an important role during this pandemic, aiming to help
instructors, schools and universities facilitate student learning during periods of
university and school closures. In addition, most of these systems are free, which can
help ensure continuous learning during this coronavirus pandemic. [6]

The success of an information system depends on the use of the system by

users. [So, in the context of e-learning during the pandemic, students' presence and
acceptance of e-learning systems should be considered. The students and teachers
face problems while learning and teaching at home. In developing countries like
Nepal, existing technological, educational/literacy and socio-economic challenges can
be a barrier to the e-learning process. [8] In the education system that existed before
the pandemic, online teaching was not the main form of education in schools and
universities, therefore most teachers had no or minimal experience in online teaching.

In addition, the current nursing curriculum in the country is not technically

designed for online learning in these unprecedented times. Students may also not
expect the academic demands required in online learning. Results from a global
survey revealed that students reported an increased workload during online learning
(Aristovnik et al., 2020). Notably, only a few students

in this study who had a very stable internet connection. This may have
affected the delivery of online courses and ultimately affected students' satisfaction
with the online learning platform. Unfortunately, internet infrastructure in the
Philippines still lags among other developing countries in Asia (Salac & Kim, 2016).
Economic costs for online classes have also been reported among nursing students in
Nepal (Deo et al., 2020). A global survey among higher education students also
reported problems with internet connectivity (Aristovnik et al., 2020). Nonetheless,
the overall effect of the factors mentioned above may have resulted in the
dissatisfaction of undergraduate nursing students. The results of this study call for
curriculum planners to carefully design and plan online curricula for nursing and
other health-related sciences with practicum courses in the next semester or even after
the pandemic. Nursing institutions should also consider factors in the literature that
affect the quality of online learning (Elumalai et al., 2020). Although half of the
students in this study had acceptable or fair academic performance, it cannot be
ignored that more than a third of the students also reported poor academic
performance. What is also remarkable is that the pandemic has significantly affected
students' performance in school. Similarly, lockdowns due to the COVID-19
pandemic have affected the academic performance of veterinary students (Mahdy,
2020). In contrast, online learning positively improved the academic performance of
nursing students in Spain (Gallego-Gómez et al., 2020). The variation in the results of
these studies may be due to the different ways of assessing students' academic
performance. discomfort among faculty members, it also allows them to seek
alternative methods by using virtual media. This helps transform traditional
classroom teaching in a short period of time. Most universities are switching to online
mode using Google meet, Microsoft Teams, Zoom, or other online platforms [7].

Online classes are the main method of providing education to students after
COVID-19 [8]. As a result of the nationwide lockdown, teachers have been forced to
run their classes online, mainly by using Zoom, Google Meet and several other
methods involving the internet. This growing trend of virtual education in Nepal's
education system has increased the familiarity of Nepali teachers, students and
parents with online classes. For most of them, it is a new experience [9]. For lessons
oriented to both practice and theory, virtual media is used in various fields of
education to ensure continuity of classes. Likewise, online education is applicable
even in the medical field where learning is done traditionally. While the concept of e-
learning is well established in developed countries, it is still new in developing
countries like ours. In Nepal's medical field, e-learning is a new approach to teaching
students. In nursing education where most of the teaching-learning activities are
conducted physically, the pandemic forced the use of classes to complete the syllabus
on time. Nevertheless, this virtual teaching method can be more difficult compared to
classroom teaching, both for teachers and students, as it takes time to get used to the
new approach.

In this regard, it is crucial to assess students' opinions and viewpoints towards

virtual approaches in the teaching and learning process. Previous research has
evaluated and identified students' perceptions and attitudes towards e-learning during
the COVID-19 pandemic. Most of those studies were from international contexts,
while the study from Nepal investigated students with non-medical backgrounds. To
our knowledge, the use of e-learning in nursing education is a new approach in Nepal.
This study was conducted to assess nursing students' attitudes towards e-learning at a
time when e-learning was the only option available to continue learning. This study is
all the more relevant in Nepal as e-learning has never been practiced on a large scale
before the pandemic. The results are expected to provide new insights into a field that
has traditionally relied on physical learning in real-life settings in laboratories and
wards to provide hands-on knowledge and skills.

We found that the availability of facilities such as desktops/laptops,

uninterrupted internet connectivity, and dedicated space to attend online classes were
more prevalent among students from higher-income families and those living in
cities. Students who do not have access to those facilities are less likely to agree that
e-learning is a good alternative to traditional classroom teaching. Therefore, for e-
learning to be more accepted by students, the government/educational institutions
should focus on providing e-learning infrastructure such as desktops, laptops, and
Wi-Fi routers at subsidized prices for students, uninterrupted high-speed internet for
students in villages

.Educator nursing (teachers, managers) must guarantee that students meet

academic requirements, and at the same time, recognize the current conditions faced
by health services and the need to simultaneously meet the demands of students,
parents, relatives, partners, and the various roles played by each individual in their
daily lives. Internationally and locally, a wide variety of criteria for learning and
evaluation, etc., have emerged, tailored to national, occupational and social contexts.
For example, and with respect to evaluation, in Berkeley (California, USA), pass/fail
grading has been proposed [10], and in Spain, the Spanish Association of Universities
(CRUE) has recommended adapting evaluation tests using distance learning
evaluation procedures [11].

Understanding students' experiences and expectations when faced with these

important changes, is essential to assist education and teaching authorities in
assigning adequate resources and redirecting university education for nursing
students. To be able to manage this situation in the near future, it is necessary to learn
from these experiences and to determine the strong and weak points. The aim of this
study was to determine the learning experiences and expectations about educational
change of nursing students enrolled in Bachelor's and Master's degrees in nursing at
two Spanish public universities, when faced with an abrupt change from face-to-face
to e-learning during the first month of quarantine due to the COVID-19 pandemic.

CONCLUSION

Developing countries like India need more cheap gadgets

(desktops/laptops/Wi-Fi routers), broadband internet services, and training in ICT
technologies to make online teaching truly successful. Despite significant problems,
students have received online classes well and have expressed their preference for
more innovative/technology-based teaching methods. Designing classes to be short in
duration, (each class <40 minutes with at least 10 minutes break between classes,
maximum 2-4 hours of classes a day) and incorporating newer teaching methods is
recommended to engage students without boredom and also reduce the need for
online teaching. risk of health problems. Additional data for this article can be found
online at https://doi.

The COVID-19 pandemic has substantially affected the academic

performance of nursing students and resulted in unparalleled stressful situations.
Stress significantly affects student satisfaction and academic performance. This study
highlights that online learning stress negatively impacts student satisfaction and
academic performance in the context of the COVID-19 outbreak. This study suggests
that interventions should be developed to reduce stress among nursing students and
help them cope with the academic challenges and demands they face during the
pandemic. While online learning may be a valuable solution to reduce virus
transmission during the COVID-19 outbreak, steps should be taken to improve the
methods used in the current learning environment to meet the learning needs of
students Rethinking how nursing education should be delivered in the months
following the pandemic may be urgently needed. A gradual resumption of face-to-
face teaching may begin once student safety is assured. In addition For example, a
blended format with limited face-to-face contact can be considered. Nonetheless, the
findings of this study suggest adopting student-centered interventions. Undergraduate
nursing students can benefit from additional psychological and academic support
during the COVID-19 health crisis which has an unparalleled impact on nursing
education.
 In our research, we found that the availability of Wi-Fi internet connectivity is
least in villages. ICT infrastructure improvements are needed in the long term.
Meanwhile, the following strategies can be adopted by universities: (1) development
of applications that can be accessed in offline mode, (2) delivering classes through
television/radio channels, and (3) delivering course materials and weekly assignments
through mail/van specialized in new information while previous information is still
being processed. This phenomenon of distraction makes learning less effective and
creates boredom. This can be prevented by: (1) keeping the teaching session

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