Effects of Distance Education Models on Senior Nursing Students' Readiness for E-learning, Self-Directed Learning and Clinical Practice: Mixed Method Design

Merlinda Aluş Tokat 1, Sevcan Özöztürk 1, Hülya Özberk 1 * , Melih Başoğlu 1, Dilek Bilgiç 1, Hande Yağcan 1, Buse Güler 1, Manolya Parlas 1, Figen Yanik 1
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1 Department of Gynecologic and Obstetrics Nursing, Faculty of Nurisng, Dokuz Eylul University, İzmir, Turkey.
* Corresponding Author
J CLIN MED KAZ, Volume 21, Issue 3, pp. 26-31. https://doi.org/10.23950/jcmk/14642
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Author Contributions:
Conceptualization, M.A.T., S.Ö. and H.Ö.; methodology, M.A.T., S.Ö., H.Ö., M.B., D.B., H.Y., B.G., M.P. and F.Y.; formal analysis, S.Ö., H.Ö., M.B., D.B., H.Y. and, B.G.; data curation, M.A.T., S.Ö., H.Ö., M.B., D.B., H.Y., B.G., M.P. and F.Y.; writing – original draft preparation, M.A.T., S.Ö., H.Ö., M.B., D.B., H.Y., B.G., M.P. and F.Y.; writing – review and editing, M.A.T., S.Ö., H.Ö., M.B., D.B., H.Y., B.G., M.P. and F.Y.; supervision, M.A.T., S.Ö. and H.Ö. All authors have read and agreed to the published version of the manuscript.


Aim: COVID-19 pandemic process has had negative effects on education. During the pandemic, the continuation of education was carried out online. The present study aimed to examine the effects of distance education models on the readiness of senior nursing students for e-learning, self-directed learning, and clinical practice.
Material and methods: This study was conducted using a mixed-method design with 58 senior nursing students in the 2020-2021 academic fall semester. Descriptive Characteristics Form, University Students' E-learning Readiness Scale, Self-Directed Learning Readiness Scale, Clinical Practice Readiness Assessment Form and focus group interviews were used.
Results: Distance education models increased the readiness of senior nursing students for e-learning and self-directed learning. In the interviews, some of the students defined online education as good preparation for the clinic, while others stated that they could not feel like a nurse in a real clinical setting.
Conclusions: Distance education as well as in face-to-face nursing education, the importance of using interactive education methods in extraordinary situations such as the COVID-19 pandemic and earthquakes has emerged.
Keywords: COVID-19; distance education; nursing students; e-learning.


Aluş Tokat M, Özöztürk S, Özberk H, Başoğlu M, Bilgiç D, Yağcan H, et al. Effects of Distance Education Models on Senior Nursing Students' Readiness for E-learning, Self-Directed Learning and Clinical Practice: Mixed Method Design. J CLIN MED KAZ. 2024;21(3):26-31. https://doi.org/10.23950/jcmk/14642


  • Evans D. How will COVID-19 affect women and girls in low- and middle-income countries? 2020. https://www.cgdev.org/blog/how-will-covid-19-affect-women-and-girls-low-and-middle-income-countries
  • The Higher Education Council Presidency. Press briefing. 2020. https://covid19.yok.gov.tr/alinan-kararlar
  • Cabı E, Kalelioglu F. A fully online course experience from students’ perspective: readiness, attitudes and thoughts. Turkish Online Journal of Distance Education, 2019;20(3):165-180. doi:10.17718/tojde.601934
  • Platt CA, Amber ANW, Yu N. Virtually the same?: Student perceptions of the equivalence of online classes to face-to-face classes. MERLOT Journal of Online Learning and Teaching, 2014;10(3):489-503.
  • Turkish Council of Higher Education. Analysis- The impact of online education during COVID-19 pandemic in Turkish higher education. 2020. https://www.aa.com.tr/en/analysis/analysis-the-impact-of-online-education-during-covid-19-pandemic-in-turkish-higher-education/2163525
  • Boztepe H, Terzioğlu F. Skill Assessment ın nursing education. Journal of Anatolia Nursing and Health Sciences, 2013;16(1):57-63. [Turkish].
  • Emin MN. Coronavirus Outbreak and Education in Emergency. 2020. https://setav.org/assets/uploads/2020/04/P268.pdf [Turkish].
  • Ullah O, Khan W, Khan A. Students’ attitude towards online learning at tertiary level. PUTAJ–Humanities and Social Sciences, 2017;25(1-2):63-82.
  • Ulenaers D, Grosemans J, Schrooten W, Bergs J. Clinical placement experience of nursing students during the COVID-19 pandemic: A cross-sectional study. Nurse Education Today, 2021;99:104746. doi: 10.1016/j.nedt.2021.104746.
  • Gómez-Urquizaa JL, Gómez-Salgadob J, Albendín-Garcíaa L, Correa-Rodrígueza M, González-Jiméneza E, Cañadas-De la Fuentea GA. The impact on nursing students' opinions and motivation of using a “Nursing Escape Room” as a teaching game: A descriptive study. Nurse Education Today, 2019;72:73–76. doi: 10.1016/j.nedt.2018.10.018.
  • Yurdugül H, Demir Ö. An investigation of pre-service teachers' readiness for e-learning at undergraduate level teacher training programs: the case of Hacettepe University. Hacettepe Unıversity the Journal of Education, 2017;32(4):896-915 doi: 10.16986/HUJE.2016022763 [Turkish]
  • Fisher M, King J, Tague G. Development of a self-directed learning readiness scale for nurse education. Nurse Education Today, 2001;21(7):516-525. doi: 10.1054/nedt.2001.0589.
  • Sahin E, Erden M. Reliability and Validity of Self-Directed Learning Readiness Scale (SDLRS). e-Journal of New World Sciences Academy, 2009;4(3):695-706. [Turkish]
  • Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology, 2006;3(2):77-101. doi:10.1191/1478088706qp063oa
  • Yildirim A, Simsek H. Qualitative research method. 2016, Ankara: Seckin Publication.
  • Alhassan RK. Assessing the preparedness and feasibility of an e-learning pilot project for university level health trainees in Ghana: a cross-sectional descriptive survey. BMC Medical Education, 2020;20:465 doi:10.1186/s12909-020-02380-2
  • Rouleau G, Gagnon MP, Côté J, Payne-Gagnon J, Hudson E, Dubois CA, et al. Effects of e-learning in a continuing education context on nursing care: systematic review of systematic qualitative, quantitative, and mixed-studies reviews. Journal of Medical Internet Research, 2019;21(10):e15118. doi: 10.2196/15118.
  • Sener Y, Sener Taplak A, Hobek Akarsu R. Views and attitudes of nursing students towards online learning during COVID-19 pandemic. Value in Health Sciences, 2022;12(1):137-146. doi:10.33631/sabd.1055486 [Turkish]
  • McDonald EW, Boulton JL, Davis JL. E-learning and nursing assessment skills and knowledge– An integrative review. Nurse Education Today, 2018;66:166-174. doi: 10.1016/j.nedt.2018.03.011.
  • 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(6):e0253651. doi:10.1371/journal.pone.0253651
  • Kabir H, Tonmon TT, Hasan M, Biswas L, Chowdhury M, Hasnat A, et al. Association between preference and e-learning readiness among the Bangladeshi female nursing students in the COVID-19 pandemic: a cross-sectional study. Bulletin of the National Research Centre, 2022;46(1):1-10. doi:10.1186/s42269-022-00697-0
  • Oducado RM, Estoque H. Online learning in nursing education during the COVID-19 pandemic: Stress, satisfaction, and academic performance. International Journal of Nursing Practice, 2021;4(2):143-153. doi:10.30994/jnp.v4i2.128
  • Lee SY, Jang SJ. High school students’ social jetlag, lifelong competency, and academic stress during the COVID-19 pandemic: a cross-sectional study. The Journal of School Nursing, 2022;10598405221094847.
  • Satır G, Beji Kızılkaya N. Electronic teaching methods in the field of healthcare. Turkish Journal of Health Sciences and Research, 2021;4(2):14-24. doi:10.51536/tusbad.870675 [Turkish]