Determinants of nursing students’ satisfaction with blended learning

In the rapidly evolving landscape of higher education, universities globally are embracing virtual learning environments, leading to the widespread adoption of blended learning that combines online and face-to-face instruction [1]. The integration of learning management systems and the use of information and communication technologies have become integral aspects of students’ lives [2, 3]. The transformative impact of technology on education was further accelerated by the global pandemic, compelling institutions to swiftly shift to distance and online learning due to the imposition of national lockdowns [4, 5].

Blended learning manifests in various forms, including web courses, web enhancement courses, and web-centric courses [6]. Each method has its unique characteristics, blending online and face-to-face elements to different extents [7]. The role of educators in the blended learning model assumes a multifaceted dimension, encompassing roles as facilitators, motivators, mentors, and counselors. This approach emphasizes a collaborative learning environment where teachers act as friends, both online and offline, fostering an open and flexible learning experience aligned with students’ needs [8, 9].

In the context of nursing education, blended learning integrates theoretical knowledge with practical application, utilizing a variety of resources such as virtual simulations, interactive modules, and instructor-led discussions [10]. This approach not only accommodates diverse learning styles but also fosters self-directed learning and critical thinking skills essential for nursing practice in today’s complex healthcare environment [11]. By seamlessly blending technology with traditional classroom instruction, blended learning in nursing education enhances accessibility, flexibility, and engagement, ultimately contributing to students’ satisfaction and competency development [12].

The significance of understanding the determinants of nursing students’ satisfaction with blended learning becomes paramount. Blended learning necessitates the effective utilization of technology, considers learner characteristics, and relies on participants’ commitment [13, 14]. Factors such as computer competency, social and family support, workload management, age, gender, and attitude emerge as crucial elements in the context of higher educational institutions [15]. Moreover, the innovative pedagogy and instructional design supporting blended learning emphasize its potential to reshape traditional education paradigms [16, 17].

Previous studies have acknowledged the multifaceted nature of student satisfaction, emphasizing the intricate interplay of diverse factors. The literature suggests that factors such as instructional design, course content relevance, and the quality of online and face-to-face interactions significantly influence student satisfaction in blended learning environments [15, 18]. Additionally, the perceived effectiveness of assessment methods and the alignment of learning objectives with students’ professional goals have been identified as critical components shaping students’ satisfaction in blended learning settings [15, 19].

In this dynamic educational experience, student satisfaction has emerged as a critical concern for higher education sponsors operating in an increasingly competitive market. It has become an integral component of quality assurance and quality enhancement efforts [20, 21]. The level of learner satisfaction, reflecting attitudes and feelings towards the advantages of blended learning classrooms, plays a pivotal role in gauging the effectiveness of this educational approach [22].

Despite the wealth of research exploring general student satisfaction in blended learning, there remains a discernible gap in the specific context of nursing education. Nursing students constitute a unique cohort with distinct educational needs and professional expectations. The scant literature addressing nursing students’ satisfaction with blended learning emphasizes the need for a targeted investigation into the determinants that resonate within this specialized field. Understanding the factors that influence nursing students’ satisfaction with blended learning is crucial for educational institutions striving to tailor their programs to meet the evolving demands of the healthcare sector [23, 24]. Therefore, this study aims to meticulously assess the determinants of nursing students’ satisfaction with blended learning, contributing valuable insights to the ongoing discourse on the effectiveness and optimization of blended learning methodologies in nursing education.

Table 1 illustrates the sociodemographic and learning characteristics of the 1266 nursing student participants, offering insights into the composition of the study’s sample. The mean age of the students was 20.47 years, demonstrating a relatively homogeneous age distribution with a low standard deviation (± 1.82). The gender distribution reveals a notable majority of female students (67.5%) compared to their male counterparts (32.5%). In terms of residency, approximately two-thirds of the participants reside in urban areas (64.8%), while the remaining third is from rural backgrounds (35.2%). Financially, 58.1% of students report having enough income, indicating a measure of financial stability within the cohort. A significant portion of the students (59.7%) is engaged in employment, suggesting a balance between academic pursuits and work responsibilities.

Examining the learning environment and resources, it is noteworthy that an overwhelming majority of students (96.2%) have access to a suitable internet source, emphasizing the ubiquity of internet connectivity among the participants. Additionally, a substantial percentage (93.4%) possess suitable electronic devices for study purposes, ensuring accessibility to online learning resources. In terms of academic pursuits, the majority of students are pursuing a Bachelor’s degree (67.3%), while the remaining 32.7% are enrolled in technical degree programs. The mean Cumulative Grade Point Average (CGPA) of 3.64 ± 2.71 provides an overview of the academic performance of the participants, reflecting a moderate level of achievement.

The distribution of students in Fig. 1 across academic years demonstrates a balanced representation, with the highest proportion in the first year (32.5%) and a gradual decline in subsequent years. Concerning technology proficiency, Fig. 2 shows that the majority of students report intermediate computer literacy (46.8%), while a notable percentage claim expertise (35.7). Lastly, Fig. 3 revealed that the preferred method of learning among participants is diverse, with a significant interest in online learning (42.8%) and blended learning (35.6%), alongside a smaller preference for face-to-face instruction (21.6%).

Table 2 provides an overview of nursing students’ satisfaction with various aspects of blended learning, with mean scores and standard deviations indicating the level of agreement or disagreement. Examining specific satisfaction items, the data reveals that student’s rate of “Interaction during the courses” is the highest, with a mean score of 3.62 ± 0.88. This relatively low standard deviation suggests a consensus among students regarding positive interaction experiences. On the other hand, “Course Management” and “Performance in the courses” receive lower mean scores of 2.69 ± 1.01 and 2.78 ± 1.08, respectively, accompanied by higher standard deviations, indicating more varied opinions. The overall “Satisfaction with blended learning” mean score of 3.21 ± 0.93 suggests a moderate level of contentment, while “Overall satisfaction” with a mean score of 3.07 ± 0.49 and a low standard deviation indicates a relatively consistent level of satisfaction across students.

Table 3 shows nursing students’ perceptions of environmental facilitators to blended learning, offering insights into factors that contribute to their learning experience. Notably, students express a high level of agreement with “Encouragements to enroll in blended learning courses,” as evidenced by a mean score of 3.99 and a moderate standard deviation of 0.85, highlighting positive support structures. Additionally, the flexibility of “Time and events of blended learning courses” is acknowledged, though with a lower mean score of 3.31 and a higher standard deviation of 0.98, indicating some variability in opinions. Students perceive the “Potential of dropout in blended learning” and the “Cost-benefit of blended learning courses” with mean scores of 3.48 ± 1.08 and 3.70 ± 0.01, respectively, suggesting moderate agreement with these factors. The overall agreement on facilitators and barriers, with a mean score of 3.62 and a low standard deviation of 0.47, indicates a generally consistent viewpoint among students regarding the factors influencing their blended learning experience.

Figure 4 of the scattered plot of multiple linear regression provide the predictor estimated against the students’ blended learning satisfaction. The plots in linear line indicating all the predictors involved in this model have p-values less than 0.05, indicating they are statistically significant in predicting satisfaction scores.

The multiple linear regression model of Table 4 identified factors influencing nursing students’ satisfaction with blended learning. Age exhibits a modest negative association with satisfaction scores (B = -0.04, p = 0.048), suggesting that, within the 95% confidence interval (-0.06 to -0.03), as students’ age increases, satisfaction marginally decreases. Female students express higher satisfaction (B = 0.25, p = 0.037) compared to their male counterparts, with a 95% confidence interval of 0.34 to 0.86. Income has a significant negative impact (B = -0.88, p = 0.033), indicating that, within the 95% confidence interval (-0.98 to -0.26), lower income is associated with lower satisfaction scores.

Conversely, employed students (B = 0.62, p = 0.040) exhibit higher satisfaction, possibly due to a sense of accomplishment or additional resources gained from employment. Access to a suitable internet source (B = 0.45, p = 0.029) positively influences satisfaction, with a 95% confidence interval of 0.53 to 0.80, emphasizing the importance of internet accessibility. Higher academic years (B = 0.47, p = 0.028), within a 95% confidence interval of 0.18 to 0.61, and computer literacy (Std beta = 0.90, p = 0.015), within a 95% confidence interval of 0.89 to 1.41, are both linked to increased satisfaction scores, highlighting positive adaptation and technological proficiency.

Notably, students who prefer blended learning (B = 1.11, p = 0.006), within a 95% confidence interval of 1.02 to 1.44, and receive encouragement to enroll (B = 0.46, p = 0.010), within a 95% confidence interval of 0.05 to 0.65, demonstrate significantly higher satisfaction. The flexibility of time and events in blended learning (B = 0.52, p = 0.035), within a 95% confidence interval of 0.21 to 0.54, positively influences satisfaction, as does the perceived cost-benefit of blended courses (B = 0.42, p = 0.013), within a 95% confidence interval of 0.08 to 0.60.

Blended learning has become a dynamic educational approach, combining traditional face-to-face instruction with online elements, creating a flexible and interactive environment for students [12]. This study assessed nursing students’ satisfaction with blended learning in academic institutions. The assessment covers various aspects, from students’ perceptions of course interactions and management to their understanding of environmental facilitators. Additionally, we use a robust multiple linear regression model to analyze the complex network of factors affecting satisfaction. The ultimate goal is to offer practical insights for educators, institutions, and policymakers looking to enhance blended learning experiences for nursing students, promoting a more personalized and responsive approach to modern pedagogy.

In assessing nursing students’ satisfaction with blended learning, the findings presented in the current study offer insights into various dimensions of their blended satisfaction experience. Notably, students uniformly express a positive attitude toward interaction during the courses, suggesting a consensus on the significance of engaging interactions. This aligns with existing literature highlighting the crucial role of interaction in fostering a sense of collaborative learning in online and blended environments [29, 30].

Conversely, course management and performance in the courses elicit lower satisfaction scores, coupled with higher variability among responses. This suggests diverse opinions and areas for potential enhancement. The reasons behind this variation may be explained by the fact that students came from different nursing programs, such as bachelor’s and technical nursing programs, each with distinct experiences. These differences likely result in varying levels of satisfaction with course management and performance in blended learning environments. This aligns with findings from studies comparing student satisfaction across different programs, which emphasize how program structure impacts the blended learning experience [31, 32].

Moreover, the literature acknowledges the challenges associated with effective course management and maintaining performance standards in online settings [33, 34]. These studies point to the need for targeted improvements in these domains to enhance overall satisfaction. The moderate overall satisfaction level in the current study reflects a balanced sentiment among nursing students. This finding is consistent with research suggesting that well-implemented blended learning can provide a satisfactory educational experience [29, 35].

Concerning nursing students’ perceptions of environmental facilitators to blended learning, the current study presents a substantial agreement among students concerning encouragements to enroll in blended learning courses highlights the positive impact of institutional support structures. This aligns with a body of studies emphasizing the important role of encouragement and institutional backing in fostering student engagement in online and blended courses [36, 37]. The robust support for enrollment suggests that proactive measures to promote blended learning within academic institutions can significantly contribute to students’ favorable perceptions and satisfaction [36, 37].

Moreover, the acknowledgment of the flexibility in time and events of blended learning courses, although with some variability in opinions, echoes findings in existing literature recognizing the diverse needs of students regarding time management in online and blended learning environments [38, 39]. This highlights the importance of designing flexible course structures that accommodate varying schedules and preferences, catering to the individualized nature of student experiences [39]. While students express moderate agreement with concerns such as the potential of dropout in blended learning and the cost-benefit of blended learning courses, the overall low variability in responses suggests a generally consistent viewpoint among students in the current study. This aligns with studies investigating barriers to online education, emphasizing the need for institutions to address concerns related to dropout potential and cost-effectiveness to enhance the overall learning experience [40, 41].

The multiple linear regression model in the current study clarifies the intricate web of factors influencing nursing students’ satisfaction with blended learning. Particularly, the modest negative association between age and satisfaction scores suggests that as students’ age increases, satisfaction marginally decreases. This finding resonates with some existing literature highlighting potential challenges older students may face in adapting to technology-mediated learning [42]. Tailored support and interventions may be beneficial to enhance the satisfaction of older nursing students in blended learning environments [43].

On a gender-related note, the higher satisfaction expressed by female students aligns with a study suggesting that female students tend to engage more actively in online discussions and collaborative activities [44]. Understanding these gender dynamics could inform instructional strategies that cater to diverse learning preferences and participation levels [45]. Additionally, the significant negative impact of lower income on satisfaction highlights the socioeconomic factors influencing students’ experiences in blended learning. This is consistent with broader literature indicating that financial constraints can hinder access to resources and technology necessary for online education [46, 47]. Mitigating these disparities through targeted support mechanisms could contribute to a more equitable educational experience [48].

In the current study, the positive association between employment and satisfaction may be attributed to the flexibility of time between work and study that is offered by blended learning and limited in face-to-face learning [49]. This finding aligns with studies emphasizing the potential benefits of balancing work and study in enhancing satisfaction in online learning [13, 49]. Access to a suitable internet source emerges as an important determinant, positively influencing satisfaction. This aligns with a wealth of studies stressing the importance of digital infrastructure in online and blended learning environments [50, 51].

The positive links between higher academic years, computer literacy, and increased satisfaction scores highlight the role of positive adaptation and technological proficiency in fostering contentment. This supports existing studies emphasizing the importance of digital literacy in online and blended learning [52, 53]. However, it is important to note that the factors associated with blended learning satisfaction, such as computer literacy and access to technology, are only part of the equation. There may be additional unexplored variables, such as institutional infrastructure, technical support availability, and faculty preparedness, that contribute to student satisfaction. Addressing these factors in future research will be critical to fully understanding the drivers of satisfaction [13, 30].

Factors such as age, gender, income, employment status, access to suitable internet sources, academic year, computer literacy, preference for blended learning, and encouragement to enroll significantly influence nursing students’ satisfaction levels with blended learning. Notably, perceptions of flexibility in time and events, as well as the perceived cost-benefit of blended courses, play crucial roles in shaping satisfaction. These findings emphasize the importance of addressing diverse student needs and enhancing support structures to optimize satisfaction and effectiveness in blended learning environments.