Satisfaction of virtual Education based on the Importance-Performance Analysis during the COVID-19 pandemic in Nursing Students: An analytical study

doi:10.21203/rs.3.rs-4950925/v1

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Satisfaction of virtual Education based on the Importance-Performance Analysis during the COVID-19 pandemic in Nursing Students: An analytical study

https://doi.org/10.21203/rs.3.rs-4950925/v1

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Background

Understanding students' satisfaction and academic performance towards virtual education helps educational planners achieve more effective virtual education to attain educational goals. This study determined the satisfaction with virtual education based on the importance-performance analysis model during the COVID-19 pandemic.

Methods

In this analytical-cross-sectional study, 200 nursing students participated using a random sampling method. The instruments used were a demographic questionnaire and a Questionnaire on students' satisfaction with virtual education based on the importance-performance analysis model. Data were analyzed using descriptive statistics and Multiple linear regression analysis in SPSS software version 16.

Results

Students' satisfaction with virtual education was higher than the average regarding importance (3.54 ± 0.60) and performance (2.80 ± 0.72). In the IPA model, 6 items with the topics of "interaction between students," "active participation," "suitability of the home environment for learning," "access to the Internet at a suitable speed," "interaction between professor and student," "access to equipment" Suitable for connecting to the Internet," were located in the first quarter of the importance-performance matrix, which, despite its high importance in determining the satisfaction of learners, did not have optimal performance.

Conclusion

In general, the facilities and conditions of virtual education need to be reformed. Students' interaction with each other and the professor, participation during training, Internet speed, conditions, and equipment needed to connect to the Internet should be considered and prioritized for improvement.

satisfaction

virtual education

COVID-19 pandemic

importance-performance analysis

nursing student

Covid-19 is an infectious disease caused by the acute respiratory syndrome coronavirus[1, 2]. Since the onset of Covid-19, this deadly virus has spread rapidly worldwide [2, 3]. According to the World Health Organization report until February 13, 2022, the total number of confirmed cases and deaths are more than 408 million and more than 5 million, respectively, worldwide, of which 133,717 deaths were reported in Iran [4, 5]. Government proceedings to deal with the risk of the spread of COVID-19 included the closure of schools and universities, business closures, curfews, and quarantine [6]. Therefore, the education sector, significantly higher education, suffered a severe disruption [7], And many universities worldwide have postponed or canceled academic activities to minimize gatherings [8]. Therefore, virtual education could solve some of these problems. Virtual education is a method for designing, compiling, presenting, and evaluating education that uses communication and information technology capabilities and facilities to help students learn without time and place limitations. In this type of education, the educational content is presented to the student through the learning management system in a multimedia form, and the possibility of communication between the student and the teacher is established online or offline for interaction and active learning [9]. Although distance learning with virtual education provides many benefits for students [10], many students do not have access to virtual education due to the lack of facilities as well as the economic and digital gap [11]; these problems cause them to be dissatisfied with this learning system [10]. Therefore, like any educational program, it is necessary to measure the satisfaction of virtual education for better planning.

Meanwhile, performance-importance analysis is an effective and valuable tool for prioritizing service indicators and increasing service quality and customer satisfaction through evaluation [12, 13]. The importance-performance analysis model is a method invented by Martila and James, and its purpose was to measure the relationship between perception and importance [14]. The importance of the performance-importance analysis model in pathology and identifying the strengths and weaknesses of the system and its efficiency in recognizing priorities and adopting improvement strategies has caused this model to be used in various research and operational fields, including health and education. Virtual learning should be used [13, 15]. The importance-performance analysis model evaluates each component from two dimensions: "importance and performance". The role of the importance-performance matrix is to help the decision-making process. This matrix is used to know the degree of priority of indicators for improvement [16]. Importance-performance analysis in evaluating and guaranteeing the quality of education and improving human resources has high power. It can diagnose the educational system fully and help the decision-making process improve and ensure quality [15].

Due to the essential role of nurses in maintaining and promoting the health of society[17] and considering the place of education in shaping the basic skills and professional abilities of nursing students, it is necessary to examine the challenges in the educational environment[18]. Although currently, the presentation and teaching of courses in most educational centers is mainly done face-to-face, since virtual education is one of the topics of interest in universities of medical sciences and the satisfaction of students and their desire for virtual education is a success[19]. This study aimed to determine the satisfaction of virtual education based on the importance-performance analysis model during the COVID-19 pandemic among nursing students.

In this descriptive-analytical cross-sectional study, 200 nursing students participated using a systematic random sampling method with proportional allocation. The inclusion criteria were as follows:

Consent to participate in the research.
Studying at the bachelor's level of nursing.
Completing a virtual training course during the COVID-19 pandemic.

Sampling was done using a systematic random method and proportional allocation. In this method, using the N/n formula, the total number of students was divided by the calculated sample size (1800/200 = 9); in this way, one student was randomly selected from every 9 students, and the student number was recorded. This method continued until the samples were sufficient.

The data collection tool in this study included two sections. The first part consists of a person's demographic information (age, gender, marital status, academic semester, overall grade point average, being native, living and working status while studying). The second part is the researcher-made Questionnaire on students' satisfaction with virtual education based on the importance-performance analysis model. This Questionnaire based on the importance-performance analysis model was taken from the questionnaires used by Mohammad Hadi et al. (2010) [16], Fathi Vajargah et al. and Bismala et al. (2021)[10, 15] and has 21 questions in two dimensions of importance and performance. This Questionnaire is based on a 5-point Likert scale. The minimum score that can be obtained from this Questionnaire is 21, and the maximum score is 105, and higher scores mean higher satisfaction. The face and content validity of the questionnaires was confirmed by a group of expert professors (11 people), and CVI for the importance dimension was 0.90, and for the performance dimension was 0.93. To estimate the reliability of the questionnaires, Cronbach's alpha coefficient and intraclass correlation coefficient (ICC) were used, which was for the importance (0.95) and performance (0.96), and The ICC value for the significance (0.888) and performance (0.879).

The Guilan University of Medical Sciences, Rasht, Iran Ethics Board approved the study protocol (reference number: IR.GUMS.REC.1401.466). In this study, the performance-importance analysis (IPA) method was also used to analyze the data. A performance-importance analysis matrix structures the IPA technique. This matrix consists of two axes: the X-axis shows its performance, and the Y-axis shows its importance. This matrix is shown in Fig. 1, which is divided into four quadrants. In each quadrant, a specific strategy was used to identify the degree of priority of the indicators for improvement (Fig. 1). The data was analyzed using IBM SPSS Statistics version 16 software.

The mean age of the 300 students participated was 22.85 (SD = 1.94) years. Of the 200 students studied, 141 (70.5%) were women, 42 (21.0%) were married, and 121 (60.5%) lived in the dormitory. Most students were studying in the nursing and midwifery faculty of Rasht (58.0%) and in the third year (50.0%). The average grade point average of the students was 17.18 (SD = 1.25), and 15 people (7.5%) were employed while studying (Table 1). The results showed that the average score for the importance of virtual education from the student's point of view was 3.54 (SD = 0.60). Their median score was 3.52 (3.95, IQR: 3.10). The average score of the total performance of virtual education from the student's point of view was 2.80 (SD = 0.72), and their median score was 2.79 (3.32, IQR: 2.24). The mean score difference between the importance and performance of virtual education from the student's point of view was 0.75 (SD = 0.79), and their median score was 0.67 (IQR: 0.05, 1.37) (Table 2).

Table 1

Personal and academic characteristics of nursing students
Variable	Category	frequency (percentage)
sex	Male	(5/29) 59
sex	Female	(5/70) 141
Marital status	Single	(0/79) 158
Marital status	married	(0/21) 42
College	Rasht	(0/58) 116
College	Langrud	(0/42) 84
Year	Second	(5/34) 69
	Third	(0/50) 100
	Fourth	(5/15) 31
GPA Mean and standard deviation		(25/1) 18/17
native	No	(5/78) 157
native	Yes	(5/21) 43
State of residence	Dorm	(5/60) 121
	private house	(0/19) 38
	student house	(5/20) 41
employment	No	(5/92) 185
employment	Yes	(5/7) 15

Table 2

Descriptive indicators of the total scores of the importance and performance of virtual education and their differences
Variable	possible domain	Viewed domain	(standard deviation) mean	(interquartile range) median
The total score of the importance of virtual education	(5, 1)	(90/4, 38/1)	(60/0) 54/3	(95/3, 10/3) 52/3
Total score of virtual training performance	(5, 1)	(95/4, 00/1)	(72/0) 80/2	(32/3, 24/2) 79/2
The difference in importance and performance scores	(4, 4-)	(29/3, 76/0-)	(79/0) 75/0	(37/1, 05/0) 67/0

In Fig. 2, as well as Table 3, the position of each item in the IP matrix is specified. According to Fig. 3–4, 6 items are located in the first quadrant (Q1, focus here) of the IP matrix and are prioritized for corrective action as reducing students' satisfaction with virtual education. 3 items were placed in the second quarter (Q2, keep up the good work) and in the acceptable area, and nursing students' satisfaction with these items is relatively satisfied. 4 items are located in the third quarter (Q3, low priority) and the indifferent region, and despite the unfavorable situation of these items, due to their low level of importance, to focus efforts and resources for correction and improvement, it has a low priority. Other items (8 items) are located in the area of waste, and resources and effort were spent in a place that did not have a prominent role in the satisfaction of students.

Table 3

Importance-performance analysis model regarding virtual education items
	object	IPA model	Weight
	object	IPA model	Original weight	Standardized weight	rank
8	Interaction and two-way communication between students	first quarter (focus here)	39/6	107/0	1
9	Active participation of students during virtual education		34/6	107/0	2
10	Suitability of home environment for virtual learning		30/6	106/0	3
11	The possibility of accessing the Internet at a suitable speed		21/6	104/0	4
7	Interaction and two-way communication between professor and student		86/5	098/0	5
12	The possibility of accessing the appropriate equipment to connect to the Internet		74/5	096/0	6
13	Mastery of the instructor on the educational content	second quarter (keep up the good work)	81/3	064/0	7
6	Comprehensibility of the materials presented in virtual education		58/3	060/0	8
5	Appropriate coordination between sound, image and text in educational content		31/2	039/0	9
15	Providing timely feedback for the materials presented by the instructor	third quarter(low priority)	48/1	025/0	10
21	The possibility of learning in different places		38/1	023/0	11
17	Suitability of the teacher's teaching method to facilitate students' learning		34/1	022/0	12
18	Suitability of students' assigned tasks in better understanding of educational content		18/1	020/0	3
19	The suitability of the evaluation method in virtual education	fourth quarter (waste of resources)	14/1	019/0	14
3	Presentation of content from simple to complex and coherence between content		14/1	019/0	15
20	The possibility of learning at different times		11/1	019/0	16
14	The instructor's ability to optimally use educational aids such as pictures, graphs, tables, charts, maps, etc.		09/1	018/0	17
16	Motivating the teacher to learn educational materials		09/1	018/0	18
1	Appropriate timing of presentation of content and course materials, assignments and tests		89/0	015/0	19
4	Up-to-date and comprehensive content in virtual education		80/0	013/0	20
2	Appropriateness of the content and appearance of the presented content		35/0	006/0	21

This study aimed to determine the level of satisfaction with virtual education based on the importance-performance analysis model during the COVID-19 pandemic in nursing students of Guilan University of Medical Sciences. The results showed that the average satisfaction score of virtual education (importance dimension) was 3.54 ± 0.60 and (performance dimension) was 2.80 ± 0.72. In explaining the findings, various studies were examined. Farsi et al.'s study showed that more than half of the students' satisfaction with virtual education was average [20]. Also, in the study of Sadeghzadeh et al. most students' average level of satisfaction was average, and their academic performance was evaluated as very good [21]. In a study conducted during the COVID-19 pandemic, Liva et al. reported that students' satisfaction with non-attendance education was medium [22]. In the studies of Farsi and colleagues, as well as Ruizgrave and colleagues, the level of satisfaction with virtual education was also moderate [23, 24]. The possible reason for this similarity is the sudden changes following the COVID-19 pandemic in all the above studies, the negative attitude of students towards virtual education [25, 26], the preference of students for face-to-face education compared to virtual education [18] and the problems in the virtual education system and There is a need for face-to-face training in the practical aspects of nursing units [11]. Meanwhile, Ebrahim et al.'s "Students' Satisfaction and Obstacles in Electronic Education among Nursing Students" study showed that 93.4% of students were delighted with virtual education [2]. The findings of the present study differed from this study's results. This inconsistency may be because, in Ibrahim et al.'s study, students' satisfaction was only divided into two levels: poor and good. Also, better access to the necessary facilities for virtual education is one of the possible factors of this inconsistency. On the other hand, conditions and sudden changes following the epidemic of Kovid-19 did not exist in this study.

Bismala et al. obtained these results that the average score of students' satisfaction with virtual education (importance dimension) was 4.23 ± 105.48, and (performance dimension) was 3.75 ± 88.78 [10]. This study's results were inconsistent with the Bismala study's results. In the current study, the average satisfaction score (importance dimension) and (performance dimension) were below average. This difference may be due to the different geographical regions and cultures that use technology in the studied populations. For many students, one of the biggest challenges of online learning is focusing on a mobile screen for long periods. In face-to-face classes, the concentration of students will be higher. Virtual education does not have a long history in our country, so it should be cultured about it. Based on the results of the study by Bismala et al. in Indonesia, 6 items in the first quarter (motivation to learn with the content and appearance of the materials, interaction with professors in the e-learning process, interaction with professors about the materials, easy reception of signals, clarity of speech Speakers' comments, speakers' feedback about the contents) are included in the IP matrix and as reducing students' satisfaction with virtual education, they are prioritized for corrective action. Resources have been spent in a place that did not significantly affect student satisfaction [10]. In the present study and the Bismala study, student-teacher interaction and virtual education infrastructure (having a device connected to the Internet and the appropriate speed of the Internet) are in the first quarter and are prioritized. The Internet is one of the challenges and disadvantages of virtual education, and the need for a suitable platform has made it impossible to use many programs or reduced the quality of their use. In addition, some people do not have the necessary tools and equipment, such as mobile phones and tablets, computer systems, etc., for training in virtual space, and due to the current economic situation, they cannot provide them, which is one of the problems.

Hetiarachchi et al.'s study showed that most participants rated their information technology literacy as average. The highest percentage of responses was recorded for the teacher's preparation for virtual teaching, which shows that most students are satisfied with the teacher's preparation for online education. Meanwhile, professors' use of technology during virtual lessons had the lowest response rate, meaning that many students wanted more satisfaction with how technology was managed during virtual education. Relatively higher percentages were also reported for dimensions such as the opportunities for teacher-student interaction during the sessions, the provision of student feedback by the teacher, and the way of continuous assessment. However, students' satisfaction was generally low in aspects such as how to conduct summative evaluation, promote interaction with peers, and the method of sharing educational materials. Poor internet connection and lack of physical presence of classmates had demotivated only a tiny percentage of the participants. Lack of opportunities for practical training is also a challenge for most students[22].

Fayaz et al. a study aimed at evaluating and improving students' satisfaction with online learning during the COVID-19 era in Pakistan, concluded that the mean of all items after modification was higher than the mean before modification. Therefore, the modification of the online program was effective in improving student satisfaction and providing evidence for students' acceptance of online learning during the pandemic. One of the critical factors that determine the level of satisfaction is students' familiarity with using technology and online tools. However, even students who expressed high satisfaction with online learning reported that they preferred a different learning method[23]. In this study, as in the present study, the effective interaction between professor and student in virtual education was challenging. Fayaz et al. (2020), a study aimed at evaluating and improving students' satisfaction with online learning during the COVID-19 era in Pakistan, concluded that the mean of all items after modification was higher than the mean before modification. Therefore, the modification of the online program was effective in improving student satisfaction and providing evidence for students' acceptance of online learning during the pandemic. One of the critical factors that determine the level of satisfaction is students' familiarity with using technology and online tools. However, even students who expressed high satisfaction with online learning reported that they preferred a different learning method [23]. In this study, as in the present study, the effective interaction between professor and student in virtual education was challenging.

Avshniuk et al. in a study investigated student satisfaction with online learning during the Covid-19 pandemic in Ukraine. The results showed increased time management ability during online research, and students reported high motivation to learn online vocational support training. The results of this study indicated high satisfaction among students in the Ukrainian educational system[25]. The results of the present study did not agree with the findings of this study. The difference in the educational system of the two countries, educational and research facilities, digital facilities, and internet access can affect the learners' satisfaction. Ziyai et al. showed that most students prefer face-to-face teaching to virtual teaching. Based on the results obtained, even though the students were able to communicate with this emerging teaching and learning method in the college, they still preferred face-to-face teaching methods, interactive methods, and being in a group in a virtual way, which shows It was that virtual methods could not replace these needs [26]. This may be because this study was conducted among medical sciences students, and students often feel that they cannot learn the practical skills needed to fulfill their professional role in the hospital in non-attendance methods. This lack of pleasant feelings continues to shadow their attitude toward virtual education [25].

Limitation

One of the limitations of this study was the use of a self-report questionnaire, which attempted to encourage the participants to adhere to the principle of honesty by assuring the students of the confidentiality of their names and identities.

In general, the results indicate an unfavorable level of satisfaction with virtual education in the dimension of importance and an average level of satisfaction with virtual education in the dimension of performance. One of the most important benefits of virtual education is its accessibility and low cost so that you can attend class while traveling, at work, or at home. Location restrictions are removed. But besides the advantages of this method, it should be noted that every student has a different learning method and a different learning style. Therefore, the virtual learning system, with many options and resources, can be personalized in many ways. This is the best way to create a suitable learning environment that suits the needs of each student. Virtual education is a new style of education, and in this way, developing infrastructure, teaching media literacy to students, and providing equipment for virtual education are among the most essential issues that must be considered. Identifying the strengths and weaknesses of professors' teaching and learning courses by students through virtual education programs should be considered in future studies.

Consent for publication

None of the authors declared

Conflict of interest
Each author has made substantial contributions to the conception and design of the study or acquisition of data or analysis and interpretation of data, drafting the article or revising it critically for important intellectual content. Each author has seen and approved the contents of the submitted manuscript. None of the authors has any personal or financial conflicts of interest.

Funding

This research This study is part of a master's thesis and receive grant from Guilan University of Medical Sciences.

Author Contribution

E.S. and M.P. designed the overall study. A.E.S. participated in the recruitment and data collection. S.M. analyzed the data. All authors read and approved the final manuscript.

Acknowledgments

The authors are very grateful to the volunteers who participated in this study, and the Guilan University of Medical Sciences, Rasht, Iran

Availability of data and materials

The data and materials that support the findings of this study are available from the corresponding author upon reasonable request.

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No competing interests reported.

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You are reading this latest preprint version

Satisfaction of virtual Education based on the Importance-Performance Analysis during the COVID-19 pandemic in Nursing Students: An analytical study

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Abstract

Background

Methods

Results

Conclusion

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Background

Methods

Results

Discussion

Limitation

Conclusion

Declarations

Consent for publication

Funding

Author Contribution

Acknowledgments

Availability of data and materials

References

Additional Declarations

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