Abstract:

Introduction:
The COVID-19 pandemic provided an opportunity to explore student preferences with remote, online, and/ or face-to-face (F2F) learning formats. Hybrid learning, a blend of remote and online technology with F2F learning, has been considered an innovative and cost-effective teaching strategy even before the pandemic. This study aimed to examine nursing student preferences for discussion and lecture formats in F2F, remote, and online classes after one year of learning in hybrid environments.

Methodology:
A cross-sectional, descriptive design was adopted, and electronic surveys were used for data collection. The sample consisted of 338 undergraduate and graduate nursing students from a research-intensive university in the eastern United States: 263 4-year undergraduate degree (BSN) students, 37 accelerated second-degree BSN (ABSN) students, 82 Doctor of Nursing Practice (DNP) students, and 25 Doctor of Philosophy (PhD). Students had experienced more than 12 months of remote learning and had options to attend F2F classes during the term of Spring 2021. Students were surveyed to select their preferences for the discussion format (i.e., in F2F classrooms, F2F large/small groups, Zoom meetings, Zoom chat box, break-out rooms, and online discussion boards) or lecture format (i.e., F2F and Zoom lectures with or without access to recordings, pre-recorded lectures) of learning.

Results:
BSN students mostly preferred F2F classroom (mean = 0.57, 95% Cl [0.51, .0.63]) and F2F small group discussions (mean = 0.52, 95% CI [0.46, 0.58]) and then preferred using the Zoom chat box (mean = 0.45, 95% CI [0.39, 0.51]). Zoom meetings and break-out rooms, and online discussion boards were not selected as frequently. The ASBN students preferred F2F large and small group discussions (mean = 0.51, 95% CI [0.34, 0.68]). DNP and PhD students preferred the Zoom meetings (mean = 0.46, 95% CI [0.38, 0.60] and mean = 0.56, 95% CI [0.35, 0.77], respectively). However, statistically the 95% confidence levels of all ABSN, DNP and PhD discussion formats overlapped suggesting that these students did not have a clear discussion preference. BSN students selected F2F lectures with access to recorded lectures (mean = 0.79, 95% CI [0.74, 0.84]) over all other lecture formats. Next, they preferred zoom lectures with access to recorded lectures (mean = 47. 95% CI [0.41, 0.53]). BSN students indicated lower preferences for pre-recorded lectures. The ABSN, DNP, and PhD students preferred Zoom and F2F lectures with access to recordings. Also, DNP and PhD preferred pre-recorded lectures in a learning management system, while this format was a second choice for ABSN students. All students did not prefer lectures without access to recordings.

Discussion:
The findings reveal undergraduate nursing students may prefer F2F learning over remote settings, whereas graduate-level nursing students may prefer remote settings more. As we move out of the COVID pandemic, there are more opportunities to blend F2F discussions and lectures with asynchronous and synchronous online modalities. Faculty should be encouraged to evaluate the different learning preferences by student level and adapt their teaching methods to maintain student engagement over time and in challenging circumstances.

Keywords:

Nursing students, student preferences, discussion, lectures, remote, online, face-to-face learning.