Experiences of students on virtual education in Iranian medical science universities during the COVID-19 pandemic: A qualitative study

Abstract

BACKGROUND:

Due to the changing environment and responding to the needs of the society, change in the traditional education system is inevitable. Also, the occurrence of events such as the COVID-19 pandemic showed that the existence of a virtual education system to prevent the cessation of education is the need of today’s society.

OBJECTIVE:

This study aimed to investigate the students’ experiences of virtual education in Iranian universities of medical sciences during the COVID-19 pandemic.

METHODS:

This qualitative study was conducted on 28 students studying in Iranian universities of medical sciences from October 2021 to January 2022 to investigate their experiences of virtual education during the COVID-19 pandemic. The participants were selected by purposive sampling. An interpretive phenomenological approach and semi-structured, face-to-face, in-depth interview were used to collect the data. The data were analyzed by Colizzi’s seven-step method.

RESULTS:

Students’ experiences of virtual education during the COVID-19 pandemic were categorized into three themes and seven sub-themes, including the strengths of virtual education (sub-themes: individual and educational dimensions), the weaknesses of virtual education (sub-themes: infrastructural, educational, tests and assignments fields), and suggestions to improve virtual education (sub-themes: infrastructural development and educational planning).

CONCLUSION:

According to the study results, the virtual education during the COVID-19 pandemic led to students staying away from the crowded centers. However, some weaknesses were also mentioned by the participants. Therefore, by anticipating requirements and needs, planning and policy making, and seriously reviewing human, financial, and support resources, virtual education can be developed and used as a supplement to face-to-face education in the future.

Keywords

COVID-19 qualitative study phenomenology student virtual education

1 Introduction

The coronavirus disease 2019 (COVID-19) has spread rapidly as the World Health Organization (WHO) introduced it as a pandemic. Due to rapid spread, this virus has infected almost all the countries of the world [1, 2]. This disease, which started with acute respiratory symptoms, was first seen in the city of Wuhan, which is the capital of Hubei Province, China [3]. The social distance was introduced as one of the solutions to reduce the critical time of the disease, as well as the cost of medicine and hospitalization, and in general the pressure on the health system. Social distancing refers to measures to reduce the number and duration of contacts and increase physical distance between people to slow the spread of an infectious disease [4]. In the meantime, at the same time with the spread of emerging new technologies and given the risk of students getting sick, especially medical students who are in direct contact with patients through practical courses, there have been significant and unprecedented changes in education and evaluation methods to ensure patients’ safety and adequate and continued education [5]. Education through television, the advance of 5 G technology in advanced countries, such as Japan and United States America (USA), as well as the creation of virtual educational networks by various universities were among the measures taken [6].

Virtual education refers to education in a learning center where educators and students are separated in terms of space or time or both. In this situation, educators deliver course content through course management programs, multimedia resources, the Internet, video conferencing, etc., and students communicate with their educators through the above methods by receiving the content [7 –9]. Performing the learning process and communicating directly with the learners through computers and the Internet, focusing on a comprehensive approach to learning, creating an inclusive system instead of a teacher-centered one, being flexible and receptive in learning, new and appropriate learning methods, repeatability, error correction and problem-solving are the capabilities and advantages of virtual education [10].

However, virtual education has always been associated with challenges, defects and problems. The lack of proper infrastructure and the lack of ability of professors in the field of information technology (IT) are among the challenges of virtual education [11]. In a study performed in Turkey during new pandemic, nursing students reported difficulties, such as access and technical problems, difficulty in attention, inadequacy, psychomotor skills, problems of communication and interaction, and health weakness, as well as profits, such as being able to spare more time for them [12]. Similarly, lack of knowledge of the tools and apps used for online education, access to a proper device, concentration problems, opening cameras during online lessons, and extra financial problems were other challenges and problems of virtual education in Iraq [13]. On the other hand, promoting this digital transformation requires the cultivation of participatory culture, and also students, professors, and administrators must work together to support and assess the changes implemented. Universities also face additional barriers to this transformation, including financial constraints and the limits imposed by the current IT infrastructure and internet quota especially in developing countries [14].

The virtual education in Iran developed in 2001 at University of Tehran [15, 16]. Although more than 20 years have passed since the development of virtual education in Iran, this education has been limited to certain universities and a few courses. This is despite the fact that if you have the right technical center and support, virtual educational centers can be used successfully for higher education [17]. With the spread of COVID-19 in the world and Iran, Iran’s universities were forced to close and started the online education without planning. Unfortunately, at the beginning of the work, neither the structures nor the professors and students made the necessary preparation. However, the outbreak of the recent pandemic provided an opportunity for the higher education system in Iran to take advantage of virtual education [18]. The educational system of universities of medical sciences across the country changed from classical and face-to-face education to virtual education based on the instructions of the Ministry of Health. NAVID University learning software (an electronic learning system) designed and launched by Iran’s Virtual University of Medical Sciences to develop virtual education in Iran’s universities of medical sciences and service integration [18].

Every training program implemented for the first time needs to be reviewed. In order to determine whether the program has reached the predetermined goals or not, the results of the training should be analyzed. Analysis is the main element of the development of any program, which is often forgotten. Analyzing the virtual training program helps the officials of the educational system to see the way of operation, the number of activities and the results of their decisions, and with this information, they can plan appropriately and respond to the needs of the society. In virtual education, the four factors of technology and its infrastructure, the content provided, educators and learners, as well as learning methods can affect the effectiveness of courses and electronic and virtual education [19]. Evaluating virtual education for various dimensions is one of the important issues that can help identify existing problems because by identifying problems, barriers and weaknesses, programs can be presented to solve these problems. On the other hand, the success of virtual education is not possible disregarding the perspective of the stakeholders. Reviewing the perspective of students as the main customers of the educational system is very important and is considered as the main factor of monitoring the quality of education [20]. It seems given the continuation of virtual education in universities due to the advance of new technologies, it is necessary to review and use the experiences and expectations of students for educational planning. Therefore, the present study was designed and conducted to explain the views of students in medical science universities on virtual education. The main question of the research was what are the students’ experiences on the virtual education provided during the COVID-19 pandemic?

2 Methods

2.1 Study design

This qualitative study was conducted by a descriptive phenomenological approach to analyze the experiences of students on virtual education in universities of medical sciences. This approach is to express the living experience of humans. According to Husserl, this process is to suspending prejudice or placing specific beliefs about the phenomenon in a specific framework to clearly see that phenomenon [21].

2.2 Participants

The subjects were students who were selected by purposive sampling. Then, the participants introduced other people and the researcher selected some of them according to the conditions. In this way, the sampling continued as snowball sampling. The selected people were those who had spent at least one semester online. They were from both groups of men and women and different fields of study who were willing to participate in this study. Also, the study exclusion criteria included only face-to-face internship courses, as well as first-year virtual education experience. In phenomenological studies, sampling should continue until saturation about the concept of the phenomenon studied. As long as the sample size increases, the added information is not significant. In this study, the above considerations were followed.

2.3 Ethical considerations

The protocol of the present study has been reviewed and approved at Ardabil University of Medical Sciences. At the beginning of the study, the interviewer provided the necessary explanations on the objectives of the study and obtained permission to record the interviews consistent with the objectives of the study. The participants were free to withdraw from the study at any stage. The participants’ names were not mentioned in any of the interviews and codes were used instead of participants’ names.

2.4 Data collection

A semi-structured, face-to-face, and in-depth interview was used for data collection. The interviews were conducted since October 2021 to January 2022. The interviews were conducted individually and in a calm place. The interviews last 30–60 minutes and in Persian language. Data were collected using open-ended questions. The researchers designed the interview guide through literature review [22, 23]. The interview guide included a main opening question “Please tell me about your experience of virtual education at university during the COVID-19 pandemic". Next, we asked other open-ended questions in detail:

What comes to mind when talking about virtual education?

What were the characteristics of the held virtual classes?

Please describe your best experiences during virtual classrooms.

Please describe your most unpleasant experiences during virtual classrooms.

What similarities and differences do you see between the training received in the current academic semester and the previous training semesters?

Please describe the teaching of professors teach and assignments of students.

What was your concern for participating in classes during the last academic semester when most of the classes were virtual?

At the end of the interview, the participants in the interview were asked to mention anything else that comes to their mind on the objectives of the study.

2.5 Data analysis

Data analysis started simultaneously with data collection. Recorded interviews were implemented immediately. Their accuracy was confirmed by researchers. The quotes were translated into English and the most prominent ones were selected. For data analysis, Collaizi’s seven-step method was used [24]. In the first step, at the end of each interview and recording of field notes, first the recorded statements of the participants were repeatedly listened to and their statements were written word by word on paper and read several more times to understand the feelings and experiences of the participants. In the second step, after studying all the descriptions of the participants, the meaningful information, and the statements related to the discussed phenomenon were underlined and, in this way, the important sentences were identified. In the third step, which was the extraction of formulated concepts, after specifying the important phrases of each interview, it was attempted to extract a concept from each phrase that expressed the meaning and the basic part of the person’s thinking (coding). Of course, after acquiring these concepts, the relevance of the meaning with the main and primary sentences was examined and the accuracy of the relationship between them was ensured. After extracting the codes, according to the fourth step, the concepts were carefully studied and categorized based on their similarity. In this way, subject categories were formed according to the concepts. In the fifth step, the results were linked together for a comprehensive description of the phenomenon studied and create more general categories. In the sixth step, a comprehensive description of the phenomenon studied (as clearly and unambiguously as possible) was presented. The final step of validation was done by referring to each sample and asking about the results. In addition, in this study, strategies such as reliability, validity, transferability, and data fit are properly considered [25]. To confirm the reliability of the results, it was attempted to describe the processes and decisions related to the research in a clear and documented manner in the research text. It should be noted that the codes were extracted independently by the authors based on the transcripts. Then, the discussions continued until reaching an agreement on the codes and topics.

3 Results

3.1 Participants

28 people participated in this study, most of whom were women (53.38%). The average age of the participants in the study was 26.32±7.15. Most of the participants were studying nursing (50%) in the 7th semester (35.71%). The information of the participants is presented in Table 1.

Table 1
Characteristics of the participants in the study (N = 28)

Variable Frequency Percent

Gender Female 15 53.38

Male 13 46.42

Field of study Nursing 14 10.72

General health 3 17.85

Midwifery 5 21.43

General medicine 6 10.72

Semester 2 2 7.14

3 5 17.85

4 2 7.14

5 2 7.14

6 1 3.57

7 10 35.71

9 6 21.42

Variable		Frequency	Percent
Gender	Female	15	53.38
	Male	13	46.42
Field of study	Nursing	14	10.72
	General health	3	17.85
	Midwifery	5	21.43
	General medicine	6	10.72
Semester	2	2	7.14
	3	5	17.85
	4	2	7.14
	5	2	7.14
	6	1	3.57
	7	10	35.71
	9	6	21.42

3.2 Themes and sub-themes

Students’ experiences were categorized into three main themes. Table 2 shows the details of the themes and sub-themes of the study.

Table 2
Themes and sub-themes

Theme Sub-theme Formulated meanings

Strengths Personal dimension Being with family, reducing living expenses, managing time, reducing the risk of the disease.

Educational dimension A separate educational system for virtual education, the use, and present of various resources by professors, flexible online class, educational files that can be used several times, problem-solving by professors, and more student participation.

Weaknesses Infrastructure Low capacity of the virtual education system, the poor internet, power outages, the high price of the Internet, not suitable equipment, and space for participating in online classes.

Education and learning Lack of social interactions, student fatigue, lack of skills of professors, lack of challenges in educational classes, reduction in learning level, lack of practice and repetition, focus on offline classes, lack of questions and answers and problem-solving.

Exam and assignment Cheat in exams, disruption in the system at the time of exams, inappropriateness of designed questions, high and non-applicable volume in the field of assignments.

Suggestions Infrastructure and educational planning Using the experiences of successful universities, providing the necessary infrastructure such as internet bandwidth, laptop, etc., holding online classes with questions and answers, practical assignments with providing feedback, correct evaluation including multiple quizzes, holding classes during a specific schedule and program, and summarizing the lessons.

Theme	Sub-theme	Formulated meanings
Strengths	Personal dimension	Being with family, reducing living expenses, managing time, reducing the risk of the disease.
Educational dimension		A separate educational system for virtual education, the use, and present of various resources by professors, flexible online class, educational files that can be used several times, problem-solving by professors, and more student participation.
Weaknesses	Infrastructure	Low capacity of the virtual education system, the poor internet, power outages, the high price of the Internet, not suitable equipment, and space for participating in online classes.
	Education and learning	Lack of social interactions, student fatigue, lack of skills of professors, lack of challenges in educational classes, reduction in learning level, lack of practice and repetition, focus on offline classes, lack of questions and answers and problem-solving.
	Exam and assignment	Cheat in exams, disruption in the system at the time of exams, inappropriateness of designed questions, high and non-applicable volume in the field of assignments.
Suggestions	Infrastructure and educational planning	Using the experiences of successful universities, providing the necessary infrastructure such as internet bandwidth, laptop, etc., holding online classes with questions and answers, practical assignments with providing feedback, correct evaluation including multiple quizzes, holding classes during a specific schedule and program, and summarizing the lessons.

In total, the experiences of the students included the strengths and weaknesses of studying in the form of virtual education during the COVID-19 pandemic. First-year students and students who were older or married and employed raised more positive points about virtual education than others, and in fact, they were more adapted to the conditions of virtual education. After pointing out the strengths and weaknesses based on their experiences, the participants made suggestions to improve virtual education.

3.2.1 Theme 1: Strengths of virtual education

The participants in this study raised the advantages of virtual education for both personal and educational dimensions. In the personal dimension, there are advantages such as being with family and having mental peace, reducing living expenses such as the cost of renting a house and the cost of traveling to and from the place of study, managing time and having enough time for study, recreation and work, being away from crowded centers and as a result of reducing the risk of the disease and the possibility of attending online classes even during the COVID-19 pandemic.

- “During the COVID-19 pandemic, with virtual education, I could manage my time better. When the education was face-to-face, I attended the class, and when I returned to the dormitory, there was little time to study because I had to do things like cooking and cleaning. But I studied more at home and had fun at the same time”-P9

- “Virtual education made us stay away from the disease and did not interrupt our studies”-P1

-“For me, as an employee of the health center, virtual education was a very good situation. I used to allocate enough time for my job, my family and my studies”-P21

For the educational dimension, advantages such as the existence of a separate educational system for virtual education with various capabilities, the use of various resources by professors to prepare educational content, the introduction and presentation of more educational resources by professors, the possibility of holding online classes at any hour of the night day, recording online classes and providing educational files that can be used several times and at desired times, problem-solving by professors through forming groups in virtual networks, strengthening student participation and searching, assignments related to taught courses, accountability and responsibility of the professors and officials of the universities to solve the problems of the students were raised.

- “Before providing the virtual education system, educational files and content were provided in apps such as Telegram and WhatsApp. Because we received messages from the channels we were members of or from friends and acquaintances while reading files, we were distracted. But Navid system, which was specially designed for virtual education with talking capability, holding exams, etc., was helpful in solving this problem”-P2

- “In addition to the students, time of the professors had increased and I felt that they were spending more time preparing educational content. They used many references to prepare educational content. The students were offered various and new references for further study”-P3

- “Some professors used to record the online class and provide it in the educational system of the faculty. Some are PowerPoint files on which the professor’s explanations were recorded. This made us refer to the file whenever we had a problem or did not understand something”-P28

- “Some professors were responsible and provided us with contact numbers and e-mails to solve problems related to the educational content. Some professors formed groups on apps such as Telegram and WhatsApp for students to ask their questions”-P7

- “Virtual education increased students’ engagement in the education process. For learning and assignments, we searched the Internet and looked for the content in reference books. During the search, we also obtained more information”-P12

3.2.2 Theme 2: Weaknesses of virtual education

The weaknesses of virtual education from the participants’ point of view were related to infrastructure, education, exams and assignments. The low capacity of the virtual education system, low speed of the Internet, power outages, the high price of the Internet, lack of suitable equipment for participating in online classes (laptop, mobile, tablet, etc.) and lack of suitable space for participating in classes were among the infrastructural problems reported by the study participants.

- “Due to the low speed of the Internet, it takes a long time to download the system uploaded files. During the online classes, the Internet was constantly disconnected and reconnected, and we were faced with audio and video interruptions. The capacity of the system was low and during the class we would leave the class automatically”- P16

- “The conditions of those like me who live in the village are different. Because there are limitations, when the online class is held, we may have guests and cannot participate in the class”-P8

- “When downloading the uploaded files, many gigabytes are used. The cost of the Internet is high for us who are students and do not have a job or income. To participate in virtual classes, we need a laptop, tablet or at least an Android phone, which are expensive”-P9

The lack of social interactions, student fatigue, lack of skills of professors, lack of challenges in educational classes, lack of a specific program for holding classes and uploading the content, reduction in learning level, lack of practice and repetition, focus on offline classes instead of online and interactive classes, lack of questions and answers and problem-solving, uploading a large amount of content and files without summarizing, and lack of educational cases were among the weaknesses of virtual education that were reported by the participants.

- “With the closure of classes, we lost face-to-face relationships with our friends. We left the atmosphere of the lesson. Because in addition to the course content, we learned other things during face-to-face education. We could not see the body language of the professors, which may have made some content unclear. On the other hand, sometimes according to our facial expressions the professor could find out that we have learned, but with virtual education, this disappeared”-P20

- “In online classes, the professor taught a topic quickly and it was removed, and further discussions and challenges were not possible. Because the professor is afraid of the Internet or power outages or the failure of the system. I feel like the learning level dropped from about 70–80% to 30–40% ”-P13

- “There was no specific schedule for uploading files and holding online classes. The files were uploaded in Navid system, but there was no notification. The hours of online classes changed many times for various reasons”-P19

- “Most of the classes were offline rather than online. Most professors provide PDF or Word files in the system. Some professors sent Power Points containing voices. Often, a large amount of educational content was uploaded without summarizing. This problem caused the lessons to be overloaded. Almost in most cases, we had to read a large amount of files in the phone or laptop, which caused fatigue and boredom”-P17

- “When we had a problem with the content, we would send a message to the professor, but the professor was not online for, for example, 5 days, and as a result, this remained unclear to us. Or, for example, during the online class, we typed our question, but the teacher did not see it, or he understood our meaning in a different way. In face-to-face class, one person may ask a question, this question would cause other questions to form in the minds of others in addition to learning, and the discussion would expand, which would lead to more learning”-P25

- “When we attended hospitals for internships, only patients with COVID-19 were referred and we were deprived of education regarding various cases. I had trouble even sampling my dissertation, because most COVID-19 patients were referred”-P26

Students stated that virtual education made it easier to cheat in exams. On the other hand, they raised weak points such as disruption in the system at the time of exams, inappropriateness of designed questions with education, and high and non-applicable volume in the field of exams and assignments.

- “Those who in the previous semesters just had passed, with the open-book exams and / or a group in apps sent each other the answers of the questions and passed with a high grade. If GPA is taken into account in the employment exam, it would be unfair to us”-P22

- “Before the exams, formal exams were taken to solve possible problems of the system. But unforeseen problems occurred during the exams. For example, the test duration was different for us and the system. The system announced the end time of the exam earlier. In the mother and child exam, when I returned to the previous question, all my answers were removed. When I brought it up with the professor, he didn’t believe me because it was a difficult lesson and thought I made an excuse”-P24

- “We were asked to do a lot of assignments. Accordingly, one person did it at a time and wrote everyone’s name. Sometimes, due to the high volume of assignments, I would give up the grade. Some professors asked us to do assignments that did not help us to learn. For example, they wanted us to ask questions about the taught lesson”-P-18

3.2.3 Theme 3: Suggestions to improve virtual education

Based on their experiences, most of the students who participated in this study made suggestions for two dimensions of infrastructure and educational planning to improve virtual education. Using the experiences of successful universities on virtual education, providing the necessary infrastructure such as internet bandwidth, laptop, etc., holding online classes with questions and answers, practical assignments with providing feedback, correct evaluation, further scrutiny of the file presented in online education, holding classes during a specific schedule and program, surveying how to hold classes, and summarizing the lessons taught were among the suggestions.

- “Since the use of today’s technologies, including virtual education, is the need of the educational community, and on the other hand the occurrence of critical situations is inevitable, the necessary predictions to provide infrastructure, including strengthening the Internet bandwidth, and even granting loans by students will be made to buy laptops and mobile phones”-P15

- “Online classes and uploading educational files should be based on the schedule. Online classes should be hold with questions and answers and maximum student participation. If the class is offline, the uploading time should be clear and voluminous files should have voices, and the more detailed information should be summed up at the end”-P6

- “Allocating reasonable time for questions and asking conceptual questions will eliminate the possibility of cheating and anyone who has really learned the content will get a grade”-P13

- “The only thing that makes virtual education effective is related assignments, numerous exams and online class presentation by students. The professor of the genetics course put conceptual questions in the system after each session, and we had three hours to answer and send the questions. This method made us learn more”-P14

4 Discussion

This study studied the experiences of students of universities of medical sciences on virtual education during the COVID-19 pandemic by a phenomenological approach. The study results included the strengths and weaknesses of virtual education and suggestions for improving virtual education based on students’ perspectives. Mousazadeh et al. in their study stated that reviewing the students’ point of view as the main customers of the educational system is very important and is considered as the main factor of monitoring the quality of education [20].

The participants in this study mentioned advantages such as being with family, reducing the cost of living and education, and being away from disease. Similarly, in a study by Bakouei et al. on virtual education during the COVID-19 pandemic, students mentioned advantages such as studying without time and place limitations, the right to select the type of course and study time, the possibility of working students participating in classes, not having physical limitations and traveling to and from the place of study and related problems [18]. Dung pointed out that virtual education during the COVID-19 pandemic provided access to a large number of students to a flexible and affordable educational program and reduced the cost of education and travel for students [26]. The study results of Shah Siah et al. showed that the students of Isfahan University of Medical Sciences had more control in electronic learning compared to learning in traditional places, could determine their objectives and plans for electronic learning and finally manage their time for electronic learning. Freedom of action in electronic learning is independent of place compared to traditional learning [27]. Convenience, savings (money and time) and the possibility of personal development have also been mentioned in a number of international studies [28, 29].

In the educational dimension, according to the students participating in this study, there are advantages such as the existence of a separate system for virtual education, the use of multiple references by professors to prepare educational content, the ability to use multiple educational files, student search, and the sense of greater responsibility of professors and university officials in solving students’ educational problems. This represented the opportunity that virtual education brought to both students and professors to seek more and richer educational content. In a study, Saad Mohammadi et al. concluded that the quality of virtual higher education in Iran for teaching-learning, content produced and access to content, access to professors was desired [30]. Heydari et al. reported user access to the virtual education system and lesson presentation obtained the highest scores from the perspective of students and faculty members, respectively [31]. In a study on virtual education during the COVID-19 pandemic, Ebrahimi et al. stated that the advantages of virtual education from the perspective of students were the elimination of transportation costs, the reduction in the stress of learning, saving time, getting out of the framework, and the possibility of recording in the class and its use at other times, preventing disease epidemics, eliminating dormitory problems for non-native students, and optimizing free time, which is largely consistent with the present study [32]. The study by Al-Zini and Abdul-Moneim during the COVID-19 pandemic in a medical college showed that online classes were mainly held in the form of lectures, topic-based sessions, and webinars. The study results showed a significant increase in problem-solving-based training during online sessions, especially among female students [33]. In a study, Nazeri et al. pointed out that easy access to educational content is one of the most important dimensions of virtual education [34], which was provided in the present study through the provision of a separate educational system. In a study, Shah Siah et al. pointed out the method of using and processing electronic information was considered as a new and important factor for students in the electronic learning system and required them to use a suitable method of searching and completing electronic information [27].

The low capacity of the virtual system, power and internet outage, and the high cost of accessing the internet and related equipment such as the Internet were among the infrastructural barriers to the use of virtual education by the participants. Similarly, in a study by Ebrahimi et al., the students faced technical problems including outages and low internet speed, technical problems of Adobe Connect software, high cost and volume of internet use, lack of technical support, power outages and educational system problems [23]. In some studies, it has been pointed out that there are no suitable conditions and places for participating in virtual education, which is consistent with the present study [35 –37]. Kohpayehzadeh et al. also acknowledged that for the development of electronic learning, the technological factor including infrastructure, network, software and hardware as a vital factor in virtual learning is required [38]. It should be noted that the establishment of virtual education in Iran’s universities of medical sciences did not have much history and the occurrence of the above problems was predictable, which was observed even in developed countries. As Golafshani et al. in a study stated, the lack of necessary software and hardware infrastructure, bandwidth limitations, the Internet costs, organizational and cultural barriers were the main barriers to the development of virtual education in developed countries at the beginning of the use of virtual education [16].

The reduction in interactions, fatigue, lack of skills of professors, lack of planning, reduction in learning level, lack of practice and repetition and focus on offline classes were among the weaknesses raised in the field of virtual education from the students’ point of view. Consistent with the present study, Curelaru et al. in a qualitative study on online education during the COVID-19 pandemic found weaknesses such as health and psychosocial problems (such as stress, anxiety, demotivation, isolation/loneliness, and apathy) and learning process problems (for example, misconceptions, lack of feedback, additional academic requirements, lack of challenge and lack of engagement) as reported by students [39]. In a similar study, professors reported problems such as lack of energy and reduced performance, while students reported lack of involvement in problem solving, not answering questions, and reduced participation [40]. According to Dreyfus study, the professor in the virtual class can never know whether the students in the class are engaged. The professor can never understand the student’s involvement in the lesson and estimate and guide his/her emerging and creative ideas [41]. Kakaei and Hakimzadeh in their study stated that the students rated the quality of content criteria, flexibility and adaptability, technical support of evaluation strategies and online guidance as undesired, and the quality of communication and interaction criteria, students’ justification, educational support, and teaching as average [42]. Another important finding of this study according to the students was the ease of cheating in exams, inappropriate evaluation and high volume and non-applicable assignments. Araghiyanmojarad et al. found cheating during exams and doing homework. They stated that students’ experiences indicate cheating for virtual exams by looking at the booklet or searching on the Internet and obtaining answers from senior students [43]. Bozorgmehr and Iranshahi in their study mentioned time-consuming assignments without justification and previous explanations as the challenges of virtual education from the students’ point of view [44].

Given the increasing needs of the people for education, the lack of economic facilities, the lack of access of the people for various reasons, including the pandemic, it seems that measures are needed to improve the strengths and resolve the weaknesses. In this study, students also gave suggestions to improve virtual education, including the development of infrastructure and equipment, proper planning, holding more interactive classes, practical assignments with feedback, summarizing and scrutinizing educational files and proper evaluation. The study results of Conceicao showed that professors compensated for the lack of face-to-face communication by strategies such as immediate feedback, differentiating managerial and personal interactions, and face-to-face communication with students based on a regular schedule [45]. In a similar study, Bakouei et al. mentioned optimization of the virtual teaching method, holding a virtual online class, uploading video files and effective evaluation as ways to improve virtual education according to the students’ views [18]. In a study, Curelaru et al. suggested using a dynamic, interactive and multipurpose online platform, modifying the teaching timetable to make it more flexible, improving online content, providing technical and pedagogical training for teachers and students before introducing new teaching systems or approaches, providing educational advice and psychological to professors and students in sensitive courses and motivating teachers and students for more online social presence for improvement [39].

4.1 Strengths and limitations

In this study, due to the simultaneous absence of students of all fields during the COVID-19 pandemic, interviews with maximum diversity were not conducted. The strengths of the study were that due to the similarity of the situation of the universities and the new nature of virtual education in Iran, the study results can be used to improve virtual education in all universities.

5 Conclusion

According to the study results, the use of virtual education during the COVID-19 pandemic led to students staying away from the crowded centers, time management and reducing the cost of living and education. However, some weaknesses were also mentioned by the participants, the most important of which is the reduction in interactions and learning. Students also gave recommendations to improve virtual education, including the development of infrastructure and equipment, proper planning, holding more interactive classes, practical assignments with feedback, summarizing and scrutinizing educational files and proper evaluation. According to the results and the necessity of implementing virtual education based on the needs of society and critical situations such as the COVID-19 pandemic, interventions should be performed to improve the quality of this educational method.

Ethical approval

Ethical permission was obtained from the Ethics Committee of Ardabil University of Medical Sciences (IR.ARUMS.REC.1399.607).

Informed consent

Informed consent was obtained from all participants before their participation in the study.

Conflict of interest

None to report.

Footnotes

Acknowledgments

The authors would like to thank the Education Development Center of Ardabil University of Medical Sciences for approval and support, and Mrs Masoumeh GholIzadeh for her valuable comments. Special thanks are extended to all participants.

Funding

The project was supported by Ardabil University of Medical Sciences.

References

Rasmussen

, Smulian

, Lednicky

, Wen

, Jamieson

. Coronavirus Disease (COVID-19) and pregnancy: what obstetricians need to know. American Journal of Obstetrics and Gynecology. 2020;222(5):415–26.

Remuzzi

A RG

. COVID-19 and Italy: what next? The Lancet 2020;11(395):10235–8.

Singhal

T. A

. A review of coronavirus disease-(COVID-19). The indian journal of pediatrics. 2020;87(4):281–6.

Faherty

, Schwartz

, Ahmed

, Zheteyeva

, Uzicanin

, Uscher-Pines

. School and preparedness officials’ perspectives on social distancing practices to reduce influenza transmission during a pandemic: Considerations to guide future work. Preventive Medicine Reports. 2019;1(4):100871.

Alsafi

, Abbas

, Hassan

, Ali

. The coronavirus (COVID-19) pandemic: Adaptations in medical education. International Journal of Surgery. 2020;78:64–5.

Jadhav

, Bagul

, Aswale

. COVID-19 era: students’ role to look at problems in education system during lockdown issues in Maharashtra, India.,International Journal of Research and Review. 2020;7(5):328–31.

Westbrook

. The virtual learning future. Teaching in Higher Education. 2006;11(4):471–82.

Spicer

, Nguyen

, Arnold

, Anderson

, Khalife

. A Faculty Development Workshop for Planning and Implementing Interactive Virtual Case-Based Teaching. MedEdPORTAL. 2021;17:11126.

Moore

, Fodrey

Distance education and technology infrastructure: Strategies and opportunities. Leading and managing e-learning: Springer; 2018. pp. 87-100.

10.

Eleftheriou

, Rokou

, Argyriou

, Papanas

, Georgiadis

. Web-based Medical Education During COVID-19 Lockdown: A Step Back or a Leap to the Future? The International Journal of Lower Extremity Wounds. 2021;21(3):272–4.

11.

Mortazavi

, Salehabadi

, Sharifzadeh

, Ghardashi

. Students’ perspectives on the virtual teaching challenges in the COVID-19 pandemic: A qualitative study. Journal of Education and Health Promotion. 2021;10:59–65.

12.

Incekar

MÇ

, Bahar

. Opinions of Nursing Students on Online Education in the Coronavirus Disease 2019 Pandemic: Qualitative Research.. Journal of Education & Research in Nursing/Hemşirelikte Eğitim ve Araştırma Dergisi. 2023;20(2):171–7.

13.

Hussein Hakeem Barzani

. Students’ perceptions towards online education during COVID-19 pandemic: An empirical study. International Journal of Social Sciences & Educational Studies. 2021;8(2):28–38.

14.

Maher

. Phenomenological study on lived experience of students and professors about virtual education during COVID-19 pandemic: Case study, University of Isfahan. Journal of Iranian Cultural Research. 2022;15(3):171–204.

15.

Esmaeilnia

, Kouhestani

, Maghul

. Design and Validation of quality improvement model of virtual learning in Farhangian University (mixed method). Technology of Education Journal (TEJ). 2019;13(2):409–27.

16.

Golafshani

SAH

, Kebriaei

, Hoseindoost

, Arani

, Ansaritabar

. Investigating the effective factors on tendency toward virtual education among the students of payame noor university in Kashan and Aran-Va-Bidgol county in 2017 ,International Archives of Health Sciences2020;7(2):64–7.

17.

Basilaia

, Kvavadze

. Transition to online education in schools during a sarscov-2 coronavirus (COVID-19) pandemic in Georgia. Pedagogical Research. 2020;5(4):em0060.

18.

Bakouei

, Arzani

, Rad

, Abbasi

. Exploration of the Students’ Perception to Virtual Education in COVID-19 Epidemic: A Qualitative Study. Journal of Nursing Education. 2021;10(1):90–5.

19.

Alqahtani

, Innab

, Bahari

. Virtual Education During COVID-19: Exploring Factors Associated With E-Learning Satisfaction Among Saudi Nursing Students. Nurse Educator. 2021;46(2):E18–22.

20.

Gholizadeh

, Valizadeh

, Khodayari-Zarnaq

, Janati

, Mousazadeh

. The Quality Assessment of Educational Services Based on Perception and Expectations of Students in Tabriz University of Medical Sciences. Future of Medical Education Journal. 2020;10(4):8–14.

21.

Osborne

. Some similarities and differences among phenomenological and other methods of psychological qualitative research. Canadian Psychology. 1994;35(2):167–89.

22.

Zaer Sabet

, pourghane

, Besharati

, khoshrang

, Ebrahiminia

. Comparing two methods of traditional and electronics tests based on attitude and experiences of medical students: A combined study. Research in Medical Education. 2020;12(3):32–43.

23.

Ebrahimi

, Alishah

, Zamanipoor

. Identify and analyze the opportunities and challenges of students’ virtual education. Journal of New Educational Approaches. 2021;16(2):15–32.

24.

Colaizzi

Psychological research as the phenomenologist views it; 1978.

25.

Connelly

. Trustworthiness in qualitative research. Medsurg Nursing. 2016;25(6):435–37.

26.

Dung

. The advantages and disadvantages of virtual learning. IOSR Journal of Research & Method in Education. 2020;10(3):45–8.

27.

Shahsiah

, Nazarpouri

, Hakak

, Vahdati

. Providing an Strategic Electronic Learning Model for the Students of the Virtual Education Center at Isfahan University of Medical Sciences. Yafte. 2020;21(4):58–73.

28.

Khan

, Nabi

, Khojah

, Tahir

. Students’ Perception towards e-Learning during COVID-19 Pandemic in India: An Empirical Study. Sustainability. 2020;13(1)57–10.3390/su13010057.

29.

Mukhtar

, Javed

, Arooj

, Sethi

. Advantages, Limitations and Recommendations for Online Learning during COVID-19 Pandemic Era. Pakistan Journal of Medical Sciences. 2020;36(COVID19-S4):S27.–S31.

30.

Saadmohammadi

, Sarmadi

, Farajollahi

, Ghorbanniadelavar

. Studying the status of virtual higher education in terms of education services provided in Iran. Research in Educational Systems. 2015;9(29):32–54.

31.

Ebrahimi

, Alishah

, Zamanipour

. Identify and analyze the opportunities and challenges of students’ virtual education. New Educational Approaches. 2021;16(2):15–32.

32.

Heydari

, Mousazadeh

, Salmani

, Mehraeen

. Assessment of virtual education during the covid-19 pandemic from the perspective of faculty members and students: a cross-sectional descriptive study in northwest Iran. BMC Medical Education. 2023;23(1):1–14.

33.

Elzainy

, El Sadik

, Al Abdulmonem

. Experience of e-learning and online assessment during the COVID-19 pandemic at the College of Medicine, Qassim University. Journal of Taibah University Medical Sciences. 2020;15(6):456–62.

34.

Nazeri

, Dorri

, Atashi

. The Effective Factors on Success of E-Learning in Medical Sciences Fields. Journal of Health and Biomedical Informatics. 2017;4(2):98–107.

35.

Bączek

, Zagańczyk-Bąk

, Szpringer

, Jaroszyński

, Wożzakowska-Kapłon

. łon B. Students’ Perception of Online Learning during the COVID-19 Pandemic: A Survey Study of Polish Medical Students. Medicine. 2021;100(7):e24821.

36.

Almendingen

, Morseth

, Gjølstad

, Brevik

, Tørris

. Student’s Experiences with Online Teaching Following COVID-19 Lockdown: A Mixed Methods Explorative Study. PLoS ONE. 2021;16(8):e0250378.

37.

Wang

, Liu

, Qian

, Parker

. Achieving Effective Remote Working during the COVID-19 Pandemic: A Work Design Perspective. Applied Psychology. 2021;70(1):16–59.

38.

kuhpayehzadeh

, Afshar por

, Naghizadeh mooghari

. Psychometric Adequacy of The Persian Version of The DELES questionnaire to evaluate the educational environment of environment of IUMS. Razi Journal of Medical Sciences. 2017;24(159):66–75.

39.

Curelaru

, Curelaru

, Cristea

. Students’ perceptions of online learning during COVID-19 pandemic: A qualitative approach. Sustainability. 2022;14(13):8138.

40.

Telyani

, Farmanesh

, Zargar

. The Impact of COVID-19 Instigated Changes on Loneliness of Teachers and Motivation–Engagement of Students: A Psychological Analysis of Education Sector. Frontiers in Psychology. 2021;12:4353.

41.

Dreyfus

About the Internet: A Philosophical Look at the Internet. Farsinezhad A, trans.Tehran: Saghi Publications; 2010. pp. 20-85.

42.

Kakaee

, Hakimzadeh

. Evaluating the Quality of E-Learning Program in Master of Information Technology Engineering at Shiraz University. Information and Communication Technology in Educational Sciences. 2016;6(23):85–110.

43.

Araghiyanmojarad

, Jouybari

, Yaghobi

. Virtual exam fraud and prevention strategies. Iranian Journal of Medical Education. 2021;21:281–2.

44.

Bozorgmehr

, Iranshahi

. A phenomenological study of shared experiences of the virtual education challenge of Farhangian University students. The 9th National Conference on Management and Human Sciences Research in Iran. 2022;1(9):1277–317.

45.

Conceicao

SCO

. Faculty Lived Experiences in the Online Environment. Adult Education Quarterly. 2006;57(26):26–45.