Online physiology teaching for nursing students during the COVID-19 pandemic – strengths, challenges and reinforcement measures

The forced shift to online education during the COVID-19 pandemic posed several challenges to Indian nursing education, especially with a complex subject like physiology. The objective of the study was to assess the apprehensions, expectations, and challenges perceived by nursing students and physiology faculty about the online mode of learning physiology, to evaluate the utility of reinforcement measures during the constraints of the pandemic, and to compare the online, offline, and blended modes. First-year nursing students (n = 100) underwent online and blended modes of physiology learning, with added reinforcement measures, during the pandemic. Beginning, mid, and end of course feedback was taken from students on the expectations and perceptions of the online mode. Feedback was obtained from students and faculty to understand the strengths and challenges of both modes. Quantitative data of student feedback were analysed using the Cochran-Mantel-Haenszel test. Thematic content analysis was used for qualitative data. Objective measures of student performance were compared using unpaired t-tests. Online learning was perceived to be more difficult than anticipated by students. ‘Comfort’ in learning and ‘time management’ were the major strengths, while ‘reduced internet connectivity,’ ‘lack of interactions’ and ‘health issues’ were the biggest challenges expressed by students and faculty. The planned reinforcement measures were ‘sometimes’ helpful in revising and improving students’ confidence. The final summative assessment scores of students showed a better performance compared to the preceding academic batch. Students and faculty expressed some advantages and several disadvantages of online learning. They preferred offline or well-designed blended learning. The reinforcement measures seemed to aid student learning. The objective measures of assessment showed that students adapted well to the online mode. A model for blended learning for 1st-year nursing education, that utilises the advantages of both modes of learning, has been proposed, which requires further validation.