EFFECTIVENESS OF ONLINE LEARNING AS COMPARED TO FRONTAL INSTRUCTION IN ACADEMIC COURSES: RESULTS OF A CONTROLLED PROSPECTIVE STUDY CONDUCTED IN FOUR ACADEMIC NURSING SCHOOLS IN ISRAEL

Background
Online learning is expanding throughout the world offering many advantages for students, such as availability of study contents unrestricted by place and time and advanced study at an individual pace. Furthermore, online learning includes unlimited opportunities to review portions of the material as often as desired, offers additional interactive study components facilitating different forms of learning, and allows practice and access to material unavailable through other study tracks. The review of literature found few studies related to online learning in Israel, especially in respect to nursing and medicine.

Aims
To examine an influence of online learning on students' achievements in a nephrology course and their satisfaction with the online learning method.

Methods
The current study employed an online introductory medical course in clinical nephrology, inserted into a study platform for maximum adaptation to individual online learning. A total of 90 students from four academic nursing schools participated. The intervention group consisted of 32 students who studied using the online course, as well as three frontal sessions with a lecturer, which focused on contextual and technical questions. The control group consisted of 58 students from three additional nursing schools who attended a traditional frontal instruction course.

Results
Average test grades of students in the intervention group (9.6 ± 2.57) were significantly higher statistically than the average test grades of students in the control group (8.4 ± 2.72), p <.05. The degree of student satisfaction in the study group was very high: 97% were of the opinion that the course was well organized, 100% believed that the instructor taught in a clear and understandable manner, 90% believed that the instructor promoted independent thinking,100% believed that the instructor used clarification examples, 91% believed that the teaching tools contributed to the learning process, and 97% believed that the teaching methods contributed to the teaching process. Average tutorial viewing time by students was 4:10 hours (SD= 3:33 hours), compared with the designated teaching time of 14 academic hours, equal to 10:30 hours devoted to frontal instruction.

Conclusions
Study results indicate higher effectiveness for the online course compared with the traditional instruction course. The subjective feedback of the intervention group points to high satisfaction of students with the online learning method. The researchers believe that the clear results of this present study reinforce the premise that online learning methods present significant potential for students of medical professions in general, and nursing in particular, and that this learning method should be further pursued and developed.