Strengths and Weaknesses of Asynchronous E-learning in Nursing Education Throughout the COVID-19 Crisis: A Qualitative Study



How to Cite

Moradi, Y. ., Baghae, R. ., Feizi, A. ., & Hajialibeigloo, R. (2022). Strengths and Weaknesses of Asynchronous E-learning in Nursing Education Throughout the COVID-19 Crisis: A Qualitative Study. Iranian Red Crescent Medical Journal, 24(6).


Background: Despite the introduction of e-learning in recent years, it has not been utilized as a major educational method in numerous universities, especially in the area of medical and health sciences, until the crisis of the COVID-19 pandemic.

Objectives: This study aimed at explaining the strengths and weaknesses of asynchronous e-learning in nursing education throughout the COVID-19 crisis.

Methods: In this qualitative descriptive study, a total of 14 nursing faculty members were selected using the purposive sampling method. The interviews were conducted face-to-face with semi-structured questions. The researcher recorded all interviews with the participants' consent. Data analysis was conducted in four phases using the content analysis approach (Graneheim and Lundman).

Results: Nursing faculty members cited "low quality of educational content", "cold and soulless education", "low efficiency in clinical education", and "insufficiency in educational assessment process" as the weaknesses and "maintenance of safe education during the COVID-19 crisis" as the strength of asynchronous e-learning in nursing education during the COVID-19 crisis.

Conclusion: Asynchronous e-learning was shown to have various weaknesses in nursing theoretical and clinical education. However, the most striking strengths of this method in the COVID-19 pandemic were found to be the protection of the safety and health of individuals, followed by the maintenance of academic activities and education. Therefore, it is worthwhile for all nurse researchers, academic education policy-makers, and faculties to put conscious effort into developing standard protocols for the preparation of educational content, empowering lecturers in the area of online education, and using other methods to promote dynamic interactions.


Wu JT, Leung K, Leung GM. Nowcasting and forecasting the potential domestic and international spread of the 2019-nCoV outbreak originating in Wuhan, China: a modelling study. Lancet. 2020;395(10225):689-97. doi: 10.1016/S0140-6736(20)30260-9. [PubMed: 32014114]

Wong LP, Alias H, Danaee M, Ziaee M, Abedi F, Ziaee A, et al. Uncovering psychobehavioural implications of SARS‐CoV‐2 infection in Iran. Transbound Emerg Dis. 2020;67(6):2892-900. doi: 10.1111/tbed.13662.

Tanveer M, Bhaumik A, Hassan S. Covid-19 pandemic, outbreak educational sector and students online learning in saudi arabia. J Entrep Educ. 2020;23(3):1-14.

Abel JR. The phenomenon of learning at a distance through emergency remote teaching amidst the pandemic crisis. AsianJDE . 2020;15(1):127-43.

Loda T, Löffler T, Erschens R, Zipfel S, Herrmann-Werner A. Medical education in times of COVID-19: German

students’ expectations–A cross-sectional study. PloS One. 2020;15(11):e0241660. doi: 10.1371/journal.pone.0241660.

Marinoni G, Van’t Land H. The impact of Covid-19 on higher education around the world. IAU Global Survey Report. 2020;102:1-3

Asarta CJ, Schmidt JR. The effects of online and

blended experience on outcomes in a blended learning environment. Internet High Educ . 2020;44:100708. doi: 10.1016/j.iheduc.2019.100708.

Amiti F. Synchronous and asynchronous E-learning. Eur J Educ . 2020;5(2):60-69. doi: 10.46827/ejoe.v5i2.3313.

Perveen A. Synchronous and asynchronous e-language learning: A case study of virtual university of Pakistan. Open prax. 2016;8(1):21-39. doi: 10.5944/openpraxis.8.1.212.

Hrastinski S. Asynchronous and synchronous elearning. Educause quarterly. 2008;31:51-5.

Shahabadi MM, Uplane M. Synchronous and asynchronous

e-learning styles and academic performance of

e-learners. Procedia Soc. 2015;176:129-38. doi: 10.1016/j.sbspro.2015.01.453.

Murphy E, Rodríguez‐Manzanares MA, Barbour M. Asynchronous and synchronous online teaching: Perspectives of Canadian high school distance education teachers. Br J

Educ Technol . 2011;42(4):583-91. doi: 10.1111/j.1467-8535.2010.01112.x.

Almaiah MA, Al-Khasawneh A, Althunibat A. Exploring the critical challenges and factors influencing the E-learning system usage during COVID-19 pandemic. Educ Inf Technol. 2020;25:5261-80. doi: 10.1007/s10639-020-10219-y.

Pérez-Villalobos C, Ventura-Ventura J, Spormann-Romeri C, Melipillán R, Jara-Reyes C, Paredes-Villarroel X, et al. Satisfaction with remote teaching during the first semester of the COVID-19 crisis: Psychometric properties of a scale for health students. PloS One. 2021;16(4):e0250739-e. doi: 10.1371/journal.pone.0250739. [PubMed: 33909704].

Hodges C, Moore S, Lockee B, Trust T, Bond A. The difference between emergency remote teaching and online learning. Educause review. 2020;27(1):1-9.

Sklar DP. COVID-19: lessons from the disaster that can improve health professions education. Acad Med. 2020;95(11):1631-1633. doi: 10.1097/ACM.0000000000003547. [PubMed: 32544103].

Turale S. A brief introduction to qualitative description: A research design worth using. PRIJNR. 2020;24(3):289-91.

Sandelowski M. What's in a name? Qualitative description revisited. Res Nurs Health. 2010;33(1):77-84. doi: 10.1002/nur.20362. [PubMed: 20014004].

Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today . 2004;24(2):105-12. doi: 10.1016/j.nedt.2003.10.001. [PubMed: 14769454]

Lincoln YS, Guba EG. But is it rigorous? Trustworthiness and authenticity in naturalistic evaluation. New dir program eval. 2004;1986(30):73-84. doi: 10.1002/ev.1427.

Singh A, Haynes M. The challenges of COVID-19 in nursing education: The time for faculty leadership training is now. Nurse Educ Pract. 2020;47:102831. doi: 10.1016/j.nepr.2020.102831. [PubMed: 32943174].

Frehywot S, Vovides Y, Talib Z, Mikhail N, Ross H, Wohltjen H, et al. E-learning in medical education in resource constrained low-and middle-income countries. Hum Resour Health. 2013;11(1):4. doi: 10.1186/1478-4491-11-4. [PubMed: 23379467].

Kheng S. The challenges of upgrading from ISPO Category II level to Bachelor Degree level by distance education. Prosthet Orthot Int. 2008;32(3):299-312. doi: 10.1080/03093640802109764. [PubMed: 18720252].

Silva CS, Souza MB, Silva Filho RS, Medeiros LMd, Criado PR. E-learning program for medical students in dermatology. Clinics. 2011;66(4):619-22. doi: 10.1590/s1807-59322011000400016. [PubMed: 21655756].

Favale T, Soro F, Trevisan M, Drago I, Mellia M. Campus traffic and e-Learning during COVID-19 pandemic. Computer Networks. 2020;176:107290. doi: 10.1016/j.comnet.2020.107290.

Alawna M, Elhadary T, Elhaty IA, Mohamed AA. Evaluation of academic performance of science and social science students in Turkish Universities during covid-19 crisis. J Crit Rev. 2020;7(11):1740-51.

Tabatabai S. COVID-19 impact and virtual medical

education. J Adv Med Educ Prof. 2020;8(3):140-3. doi: 10.30476/jamp.2020.86070.1213. [PubMed: 32802908].

Suliman WA, Abu-Moghli FA, Khalaf I, Zumot AF, Nabolsi M. Experiences of nursing students under the unprecedented abrupt online learning format forced by the national curfew due to COVID-19: A qualitative research study. Nurse Educ Today. 2021;100:104829. doi: 10.1016/j.nedt.2021.104829. [PubMed: 33740705].

Santos LMD. The Relationship between the COVID-19 Pandemic and Nursing Students’ Sense of Belonging: The Experiences and Nursing Education Management of Pre-Service Nursing Professionals. Int J Environ Res Public Health. 2020;17(16):5848. doi: 10.3390/ijerph17165848. [PubMed: 32806697].

Elsalem L, Al-Azzam N, Jum'ah AA, Obeidat N, Sindiani AM, Kheirallah KA. Stress and behavioral changes with remote E-exams during the Covid-19 pandemic: A cross-sectional study among undergraduates of medical sciences. Ann Med Surg (Lond). 2020;60:271-9. doi: 10.1016/j.amsu.2020.10.058. [PubMed: 33163179].

Chirumamilla A, Sindre G, Nguyen-Duc A. Cheating in e-exams and paper exams: the perceptions of engineering students and teachers in Norway. Assess Eval High Educ. 2020;45(7):940-57. doi: 10.1080/02602938.2020.1719975.

Mohmmed AO, Khidhir BA, Nazeer A, Vijayan VJ. Emergency remote teaching during Coronavirus pandemic: the current trend and future directive at Middle East College Oman. Innov Infrastruct Solut. 2020;5(3):1-11. doi: 10.1007/s41062-020-00326-7.

Gilbert B. Online learning revealing the benefits and challenges. 2015.

Thomson DL. Beyond the classroom walls: Teachers' and students' perspectives on how online learning can meet the needs of gifted students. J Adv Acad. 2010;21(4):662-712. doi: 10.1177/1932202X1002100405.