الفهرس 
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Abstract
Blended learning has been described as the convenient combination of face-to-face teaching and online approaches and learning technologies that provide synchronous and asynchronous teaching tools and educational strategies (Moorhouse et al., 2022).
Technology has changed the face of higher education. Initially, traditional face-to-face learning was the only form of instruction where both instructor and students met physically in a brick-and-mortar school (Singh et al., 2021).
During the 1990s online learning also started gaining popularity, as students were able to complete their course work asynchronously without coming to campus and being physically present in classroom (Jones, 2019).
It is also important to note that academic administrators felt that online learning could replace in-person learning, as it was an economically viable option for students. As a result, there was an increased push to increase online course offerings in mid-1990s (Felson et al., 2021).
Blended learning was the potential to create additional opportunities as allowed to be included in in-person instruction on a regular basis (Gallagher et al., 2020).
Blended learning is an advanced model that encompasses the advantages of both traditional teachings in the classroom, information, and communication technology (ICT) supported learning. Blended learning requires rigorous efforts, the right attitude, a handsome budget, and highly motivated teachers and students for its successful implementation (Lalima and Dangwal, 2017).
Aim of the study
This study aims to assess attitude and satisfaction of pediatric nursing students’ regarding to blended learning during era of post COVID 19 through:
Assessing attitude of pediatric nursing students toward blended learning during era of post COVID 19.
Assessing satisfaction of pediatric nursing students toward blended learning during era of post COVID 19.
The present study was carried out through the four main designs as follows:
I. Technical design.
II. Operational design.
III. Administrative design.
IV. Statistical design
I) Technical design:
The technical design includes research design, setting, subject and tools of data collection.
Research design:
A descriptive study was utilized to achieve the aim of the study.
Research Settings:
This study was conducted at the Faculty of nursing affiliated of Ain Shams University in the pediatric nursing class.
Subject:
A convenience sample of 400 pediatric nursing students at the third years in the second semester. in the previously mentioned study settings regardless of their characteristics over 3 months. The sample size was1estimated1by1400 students using1the1sample1size1formula
n=(N×P(1-P))/([N-1×(d2÷Z2)]+P(1-P))
Tools of the study:
There are three tools of Data Collection:
І-Pre-designed Questionnaire Sheet.
Part (1) Structure interview questionnaire. It was designed by the investigator after reviewing the related literature, it was written in an Arabic language for gathering data in relation to the characteristics of pediatric nursing students: included. Age, gender, academic year, residence, and mode of access to onlin educational courses.
Part (2). Pediatric nursing students’ knowledge according to their online courses included: mode of access to onlin educational courses, Internet sources to accessing online courses and participated in blended learning.
Part (3) Pediatric nursing students’ knowledge related COVID 19 included concepts, mode of transmission, signs and symptoms, complication, prevention precautions and vaccination.
II- Students’ Attitude Questionnaire Sheet:
This tool was adopted from Tang and Chaw, (2020) and aimed to assess students’ attitudes towards several dimensions of blended learning. The instrument consists of 34 items that measure students’ attitude towards six different aspects of blended learning: learning flexibility (4 items); online learning (8 items); study management (6 items); technology (4 items); classroom learning (5 items) and online interaction (7 items) with 5-point Likert Scale ranging from ‘1-strongly disagree’ to ‘5-strongly agree’:
Scoring System: Student’s response will be classified as “strongly agree”, “agree”, “natural”, “disagree” and “strongly disagree” and was respectively scored 5,4,3,2 and 1. The scoring was reversed for negative statements; the scores of the items was summed up and was converted into a percentage score then all data was classified into 2 categories:
Positive attitude if score: ≥ 70%
Negative attitude if score < 70 %.
III- Student Satisfaction Survey Form (SSSF):
It adopted from Naji et al., (2020) which consists of 35 items on a 5-point Likert Scale, ranging from ‘1-strongly dis-satisfy’ to ‘5-strongly satisfy’. It addresses elements integral to student satisfaction in blended learning environments. The thirty-five items were addressed under the following five student satisfaction elements: instructor (5 items), technology (6 items), class management (3 items), interaction (9 items), and instruction (12 items).
Scoring System: Student’s response was classified as “strongly satisfy”, “satisfy”, “natural”, “dissatisfy” and “strongly dissatisfy” and was respectively scored 5,4,3,2 and 1. The scoring were reversed for negative statements; the scores of the items were summed up and were converted into a percentage score then all data will be classified into 2 categories:
Satisfied if score: ≥ 80%
Unsatisfied if score: < 80%.
II) Operational Design:
The operational design included preparatory phase, content validity, tool reliability, pilot study and field work.
The preparatory Phase:
It included reviewing of related literature and theoretical knowledge of various aspects of the study using textbooks, articles, scientific journals, internet’s periodicals and websites to develop tools for data collection were developed and then translated into Arabic language.
Content validity was done by a jury of five in the fields of pediatric nursing at Ain Shams University.
Reliability of the adapted tools had been done after reviewing literature using Cronbach´s coefficient alpha test (0.790).
Tools Cronbach Alpha Coefficient
No of items Reliability Coefficient Cronbach alpha
1. structure interview questionnaire about characteristics of pediatric nursing students: 10 0.025 0.608
2-Pediatric nursing students’ knowledge according to their online courses 3 0.0075 0.75
3- structure interview questionnaire about Pediatric nursing students’ knowledge related COVID 19 5 0.0125 0.304
4-Assessing attitude of pediatric nursing students toward blended learning during era of post COVID 19. 34 0.69 0.601
5- Assessing satisfaction of pediatric nursing students toward blended learning during era of post COVID 19. 35 0.78 0.720
Pilot study:
A pilot study was carried out on 10% (40) of the expected sample size to test the clarity, applicability, feasibility, and relevance of the tools used, as well as to determine the needed time for the fill out of the study tools. The students who were included in the pilot study were included in the study subjects because no modification was done after conducting pilot study.
Ethical considerations:
Approval of the study protocol was obtained from the ethical committee of the faculty of nursing at Ain Shams University before starting the study. The investigator clarified the objective and aim of the study to the students included in the study. The investigator assured maintaining anonymity and confidentiality of the subjects’ data. Students were informed that they were allowed to choose whether to participate or not in the study and that they had the right to withdraw from the study at any time without giving any reasons.
Field work:
Once permission was granted to proceed with the study, actual data collections were carried out in the period from February to April in 2023. It was included in the implementation of the study where data was gathered through individual interviews with students. The purpose of the study was simply explained to the students under the study before data collection.
The study data was conduct 1 day per week (Wednesday) during morning lectures from 9am-1pm in faculty of nursing, pediatric class to collect the study data the researcher started the interview with 4 groups of students each group composed from 50 student using the data collection questionnaire. The researcher explained the aim of the study and the expected outcome.
The time consumed to fill out the full questionnaire ranged from 15 to 20 minutes. The investigator visited each study setting 1 time/week from 9-1pm by rotation to collect data and implement the study. Data collection lasted for 3 months. The collected data was checked with a model key answer and accordingly, their perception was evaluated. Protective measures were followed during the interview.
III) Administrative Design:
Approval was obtained through an issued letter from the Dean of Faculty of Nursing, Ain Shams University to Head of Pediatric Nursing Department- Ain Shams University of the previously mentioned setting, explaining the purpose of the study to obtain permission for conducting this study.
IV) Statistical Design:
The collected data were organized, categorized, tabulated, and statistically analyzed using the statistical package for social science (SPSS) version (20) to assess to the attitude and satisfaction of pediatric nursing students regarding blended learning during era of post COVID 19. Data were presented in tables and graphs. The statistical analysis included percentage (%), the arithmetic mean ( ), standard deviation (SD), chi-square (X2).
Test of association: Chi-square test to compare between two or more groups. Pearson’s correlation coefficient (r) test was used to assess the degree of association between two sets of variables.
Proportion probability of error (P-value).
The observed differences and associations were considered as follows:
P > 0.05 non significance (No difference)
P ≤ 0.05 significance difference
P < 0.001 highly significance difference
Results:
Findings of the current study can be summarized as the following:
The findings illustrated that more than one third (37.5%) of studied pediatric nursing students their age was ranged between 20 to 21 years with S.D 33.57±5.54. Females were more prevalent in the study sample than males; they constitute more than half (57.0%) of studied pediatric nursing students and nearly one (96.2%) unmarried.
It illustrated the megority of them (90%) had tablets access to online courses and also more than two third (72.5%) uesed wi-fi internt sources when accessing online courses while more than two third (75%) didn’t participated in blended learning.
The results represented total attitude levels among studied pediatric nursing students toward blended learning, it illustrated that most of studied students (84.2%) had positive attitude toward blended learning.
It illustrated that the majority (90.2%) of studied pediatric nursing students were unsatisfied toward blended learning while 9.8% of them were satisfied.
It reported the relation between total attitude of studied pediatric nursing students’ and their characteristic It showed that their was statisticall significant differance relationship between pediatric nursing gender and their total level of attitude where P=.005**.
It showed Relationship between characteristics of studied pediatric nursing students’ and total satisfaction level It showed that their was statisticall significant differance relationship between pediatric nursing gender and their total satisfaction level where P= .005**.
It illustrated the correlation between attitude total score and satisfaction total score among studied pediatric nursing students sample. This table showed statistically non-significant weak negative correlation between total student attitude total score and their total satisfaction scores (r=.-040, p=.425).
Conclusion
Based on the findings of the current study, it can be concluded that most of studied nursing students have positive attitude toward blended learning at the era of post COVID 19 pandemic. The majority of them were unsatisfied toward blended learning. Additionally, there was non-significant negative weak correlation between total attitude scores and total satisfaction scores toward blended learning among studied sample.
Recommendations
In the light of the study findings, the following recommendations were proposed:
Conduct community mobilization campaigns to boost the community awareness about crisis to change negative vaccine attitudes and increase the acceptance and uptake of vaccines.
Establish a health education program about crisis and protective behaviors and vaccines to keep a vigilant eye to fight misinformation.
Enhance education and training, including personal protection, hand hygiene and occupational exposure management in the faculty.
Conducting educational programs for increasing knowledge and perception related to blended learning is necessary to upgrade students’ during crisis
Involve blended learning as an alternative plan at the time of crisis.
Encourage students for more usage of internet websites to implement all courses activities.
Encourage the students to discuss the barriers for using blended learning.