Knowledge, Attitudes and Associated Factors Toward Blended Learning Among Nursing Students in Selected Nursing Schools in Buea, Cameroon

Background: Blended learning represents an innovative pedagogical approach combining online and face-to-face instruction, increasingly adopted in nursing education globally. Understanding nursing students' knowledge, attitudes, and associated factors toward blended learning is essential for successful implementation in resource-limited settings.
Objective: The aim of this study was to evaluate the knowledge, attitudes and associated factors towards Blended learning in selected Nursing Schools in Buea.
Methodology: A school-based cross-sectional study was conducted from the 1st of December, 2023 to 31st July, 2024 in three nursing schools in Buea, Cameroon. Using multi-stage sampling, 385 nursing students were recruited. Data were collected using structured a questionnaire and analyzed using SPSS version 27. Chi-square tests determined associations between sociodemographic characteristics and knowledge and attitudes, with statistical significance set at p<0.05. Descriptive statistics summarized data, and Pearson correlation assessed relationships between variables.
Results: The mean age of participants was 22.55 years. Overall, 335 (87.0%) students demonstrated adequate knowledge of blended learning, while 375 (97.4%) exhibited positive attitudes toward this pedagogical approach. Chi-square analysis revealed significant associations between knowledge and sex (p=0.001), academic institution (p=0.023), and religion (p=0.036). Similarly, attitudes were significantly associated with academic level (p=0.012) and prior technology experience (p=0.008). Pearson correlation analysis demonstrated strong positive correlations between knowledge and attitudes (r=0.674, p<0.001). Multivariate analysis identified female gender (AOR=2.34, 95% CI: 1.45-3.78, p<0.001) and enrollment in private institutions (AOR=1.89, 95% CI: 1.12-3.21, p=0.017) as independent predictors of adequate knowledge.
Conclusion: Nursing students in Buea demonstrated adequate knowledge and overwhelmingly positive attitudes towards blended learning. However, significant disparities exist based on gender, institutional affiliation, and technological exposure, necessitating targeted interventions to ensure equitable adoption of blended learning approaches in nursing education.

Blended learning, Nursing education

1. Al-Fraihat, D., Joy, M., & Sinclair, J. (2020). Evaluating e-learning systems success: An empirical study. Computers in Human Behavior, 102, 67-86. [Google Scholar] [Crossref]

2. Chigona, A., Chigona, W., Kausa, M., & Kayongo, P.(2010). An empirical survey on domestication of ICT in schools in disadvantaged communities in South Africa. International Journal of Education and Development using Information and Communication Technology, 6(2), 21-32. (Referenced via original archive) [Google Scholar] [Crossref]

3. Davis, F. D. (1989). Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS Quarterly, 13(3), 319-340. [Google Scholar] [Crossref]

4. Dewart, G., Corcoran, L., Thirsk, L., & Petrovic, K.(2020). Nursing education in a pandemic: Academic challenges in response to COVID-19. Nurse Education Today, 92, 104471. [Google Scholar] [Crossref]

5. Duong, V. A., Nguyen, T. T., & Tran, T. (2012). Effectiveness of blended learning in teaching mathematics to Vietnamese students. Journal of Mathematics Education in Southeast Asia, 35(2), 45-62. [Google Scholar] [Crossref]

6. Fozdar, B. I., Kumar, L. S., & Kannan, S. (2006). Study of the factors responsible for the dropouts from the BSc programme of Indira Gandhi National Open University. International Review of Research in Open and Distance Learning, 7(3), 1-15. [Google Scholar] [Crossref]

7. Khalid, A. (2012). Factors and barriers influencing attitudes toward blended learning at Jazan University. International Journal of Technology Enhanced Learning, 4(3/4), 172-185. [Google Scholar] [Crossref]

8. Kintu, M. J., Zhu, C., & Kagambe, E. (2017). Blended learning effectiveness: The relationship between student characteristics, design features and outcomes. International Journal of Educational Technology in Higher Education, 14, 7. [Google Scholar] [Crossref]

9. Kuo, Y. C., Walker, A. E., Schroder, K. E., & Belland, B. R. (2014). Interaction, internet self-efficacy, and self-regulated learning as predictors of student satisfaction in online education courses. The Internet and Higher Education, 20, 35-50. [Google Scholar] [Crossref]

10. Liu, Q., Peng, W., Zhang, F., Hu, R., Li, Y., & Yan, W. (2016). The effectiveness of blended learning in health professions: Systematic review and meta-analysis. Journal of Medical Internet Research, 18(1), e2. [Google Scholar] [Crossref]

11. Lwoga, E. (2014). Critical success factors for adoption of web-based learning management systems in Tanzania. International Journal of Education and Development using Information and Communication Technology, 10(1), 4-21. [Google Scholar] [Crossref]

12. McCutcheon, K., Lohan, M., Traynor, M., & Martin, D. (2015). A systematic review evaluating the impact of online or blended learning vs. face-to-face learning of clinical skills in undergraduate nurse education. Journal of Advanced Nursing, 71(2), 255-270. [Google Scholar] [Crossref]

13. Mukhtar, K., Javed, K., Arooj, M., & Sethi, A. (2020). Advantages, limitations and recommendations for online learning during COVID-19 pandemic era. Pakistan Journal of Medical Sciences, 36(COVID19-S4), S27-S31. [Google Scholar] [Crossref]

14. Nkomo, L. M., Daniel, B. K., & Butson, R. J. (2020). Synthesis of student engagement with digital technologies: A systematic review of the literature. International Journal of Educational Technology in Higher Education, 18, 34. [Google Scholar] [Crossref]

15. Oducado, R. M., Rabacal, J., Moralista, R., & Tamdang, K. (2021). Perceived stress due to COVID-19 pandemic among employed professional teachers. International Journal of Educational Research and Innovation, 15, 305-316. [Google Scholar] [Crossref]

16. Porter, W. W., Graham, C. R., Spring, K. A., & Welch, K. R. (2014). Blended learning in higher education: Institutional adoption and implementation. Computers & Education, 75, 185-195. [Google Scholar] [Crossref]

17. Rasheed, R. A., Kamsin, A., & Abdullah, N. A. (2020). Challenges in the online component of blended learning: A systematic review. Computers & Education, 144, 103701. [Google Scholar] [Crossref]

18. Rowe, M., Frantz, J., & Bozalek, V. (2012). The role of blended learning in the clinical education of healthcare students: A systematic review. Medical Teacher, 34(4), e216-e221. [Google Scholar] [Crossref]

19. Saovapa, W. (2018). Significant predictors for effectiveness of blended learning in a language course. Turkish Online Journal of Distance Education, 19(1), 56-69. [Google Scholar] [Crossref]

20. Setia, M. S. (2016). Methodology series module 3: Cross-sectional studies. Indian Journal of Dermatology, 61(3), 261-264. [Google Scholar] [Crossref]

21. Vallée, A., Blacher, J., Cariou, A., & Sorbets, E. (2020). Blended learning compared to traditional learning in medical education: Systematic review and meta-analysis. Journal of Medical Internet Research, 22(8), e16504. [Google Scholar] [Crossref]

22. Venkatesh, V., Morris, M. G., Davis, G. B., & Davis, F. D. (2003). User acceptance of information technology: Toward a unified view. MIS Quarterly, 27(3), 425-478. [Google Scholar] [Crossref]

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