Our data analysis showed that students’ learning strategies for e-learning during the pandemic fall into three main themes of “self-centered learning strategies”, “collaborative learning strategies” and “Remaining passive” (Table 1). Using direct quotes from the participants, the themes and their sub-themes are presented below.
Table 1
Students' learning strategies in e-learning
Code | Sub-theme | Theme |
Searching the Internet | Exploration | Self-centered learning strategies |
Asking peers |
Asking teachers |
Studying reference textbooks | Using evidence |
Studying relevant articles |
Attending educational webinars | Using educational media and tools |
Using educational systems and software |
Using educational Telegram channels |
Watching educational videos | Using audio-visual resources |
Listening to narrated PowerPoint slides |
Dedicating a quiet and comfortable place for studying | Dedicating a place for studying |
Dedicating a particular place for studying |
Classification and summarization of content | Summarizing and note-taking |
Note-taking |
Reflection on the narrated PowerPoint slides | Reflection on the materials taught |
Reflection on educational videos |
Skimming the content in the first round of studying | Skimming | |
Trying to understand the main idea |
Playing the role of a teacher | Individual role playing |
Teaching to hypothetical students |
Forming groups for note-taking and pamphlet writing | Collaborative note-taking and pamphlet writing | Collaborative learning strategies |
Division of responsibilities in note-taking and pamphlet writing |
Uploading the group pamphlet |
Forming a group of peers | Peer-to-peer teaching and learning |
Division of teaching materials between group members |
Teaching the materials to one another |
Giving up | Giving up and not taking action | Remaining passive |
Not taking action |
Theme 1: Self-centered Learning Strategies
This theme includes the following 9 sub-themes: “Exploration”, “Using evidence”, “Using educational tools and media”, “Using audio-visual resources”, “Dedicating a particular space for studying”, “Summarizing and taking notes”, “Reflection on the content taught”, “Skimming” and “Individual role playing”.
Exploration
Many students stated that they used this strategy when they were faced with some professors' inadequate teaching and when some topics raised questions or were ambiguous for them. Exploration manifested itself in a variety of behaviors that include “searching the Internet”, “asking the teacher” and “asking peers”. However, the students’ first choice to solve their learning problems was to search the Internet, which was followed by questions from peers and questions from teachers. The following quotes shed more light on how and why these solutions were adopted by the students.
“I used to search and download educational videos available on Google. For example, when the teacher taught CPR, I did not learn it very well and didn't know where exactly I should place these leads. That’s why I searched the Internet and found a related video.” (Participant 7, 7th semester female student)
“If I happened to have a problem, I would first search the Internet, and if I couldn't find the answer, I would ask one of the classmates who knew the answer.” (Participant 9, 8th semester female student)
“Some of the professors were really good. They gave us their numbers and we could ask them in case we had a problem.” (Participant 12, 6th semester male student)
Using Evidence
Based on the experiences of our participants, using evidence involved reading reference textbooks and reading relevant scientific articles. Students used this strategy when the topics were inadequately presented by the professor or when they did not understand the topics well despite the professor's good teaching.
“For example, I had the professor’s pamphlet and the content file, but I felt that the teaching materials were not complete, so I used to supplement those materials from different books to help me learn.” (Participant 8, 6th semester female student)
“For some of things that I had problem with such as some points in anatomy, I would look up the answer in books. Or in physiology, for example, I again studied the heart physiology from scratch so that I could understand the different axes. Although the teacher had taught very well, I myself felt that I did not understand, so I read the book again. Or I used the materials and articles that were available on the Internet.” (Participant 3, 4th semester female student)
Using Educational Tools And Media
According to the experiences of our participants, this strategy included participation in educational webinars, using educational systems and software (Full Code Medical Simulation, Labster, and Faradars), and using Telegram educational channels. Some students stated that in order to better learn the topics in which they felt weak, they participated in educational webinars, which often cost them money:
“Yeah, these webinars are very good. I myself attended a webinar on pharmacology. Of course, I paid a fee to participate, and then the topics were taught very nicely; for example, beta blockers or calcium blockers; these were taught in a nice way using diagrams and also audio files explaining the topics very well. I myself participated in these. For example, I was weak in the pharmacology course, so I participated in these and it was very good.” (Participant 1, 4th semester female student)
In addition, since practical/clinical topics are not presented to students efficiently in electronic education, some students, especially those who are already familiar with the basics of virtual education, will use the strategy of using simulator software and systems to learn these topics.
“Yeah, these apps helped me a lot, because you can go step by step. I had never been to hospital, but when I was working with Full Code, although it was in English, I understood that as a nurse, I am allowed to do some examinations. I mean, I used it to learn physical examination. In addition to Full Code, there is another system called Labster, which is completely designed so that you can wear gloves and a gown, or plug the microscope in, all in that simulation space. So much attention has been paid to the details. This app was one of the things that I used for the laboratory courses.” (Participant 5, 5th semester female student)
“I think Faradars system belongs to Tehran University of Medical Sciences, which has some packages that you can buy; for example, you can go and buy content, and some may post free tutorials, and I used to use these tutorials. For example, I used this system to learn NG-Tube placement and also to get familiar with endoscopy and other things.” (Participant 1, 4th semester female student)
Using Audio-visual Resources
Another strategy adopted by the interviewed students was using audio-visual educational resources. This included watching educational videos and listening to narrated PowerPoint slides. This strategy was mostly used by students who had a visual-auditory learning style.
“Because I myself learn better through videos, I prefer watching videos. For example, I found a video clip about CPR. I saw that clip and it was very good.” (Participant 12, 6th semester male student)
“I have a habit of having someone explain things to me, and I listen to learn. What I used to do was listen to the teacher's voice. When I was idle, I used to listen to the teacher's voice. In my mind, when I heard the teacher's voice it looked as if the lesson had been repeated for me. Lessons that were repeated were very good.” (Participant 8, 6th semester female student)
Summarizing And Taking Notes
Another self-centered learning strategy the students participating in the present study used, especially those with a reading/writing learning style, was summarizing and note-taking. Students stated that the flexibility of e-learning facilitated the use of this strategy. Taking notes and summarizing helped these students to review the educational material faster when studying for final exams.
“Well, I’m used to writing in order to learn. In e-learning, I had more time to categorize the materials I was supposed to learn. I made a table for myself. The night before the exam, for example, I could easily distinguish between different diseases or the symptoms of different diseases by reading them on a table. It took me much less time.” (Participant 4, 6th semester female student)
Dedicating A Particular Place For Studying
Some students stated that they dedicated a particular place for studying to facilitate their learning. Such a place, according to the participants, had to be quiet and comfortable.
“I used to choose a place to study that was comfortable and without noise. Besides, it had to be a particular place so that my brain would know that it was time to study. Well, this made me learn better and learn faster.” (Participant 2, 4th semester female student)
Reflection
Reflection on the educational materials was another self-centered learning strategy adopted by some students to learn the topics more deeply.
“After I listened to the professor's narrated PowerPoint [slide] or watched an educational video, I would think about those contents and make an analysis for myself of that PowerPoint [slide] or video” (Participant 6, 5th semester female student)
Skimming
Some students believed that using the skimming strategy led to better learning of the topics. This strategy helped them understand the main idea of the educational material and learn the topics more quickly the next time they study the same content.
“Another thing I do is, for example, to read the entire article quickly and then come back to the beginning. Now that I have read it once, I have a general idea about it, and then I read it again in more detail. This makes me learn better.” (Participant 8, 6th semester female student)
Individual Role Playing
Playing the role of a teacher was another self-centered learning strategy used by some students. These students stated that for a better and deeper understanding of the course material, they imagined themselves to be one of the professors and then taught the topics to hypothetical students.
“One of the methods I used, in addition to summarizing the teacher’s voice, was to play the role of the teacher for myself by giving a lecture. I mean, I imagined myself as a teacher and put myself in shoes of Professor X or Y, and I would explain what he or she said to myself, as if I had students and I was the professor and I was teaching the lesson to my students. This way, my efficiency would be much higher.” (Participant 7, 7th semester female student)
Theme 2: Collaborative Learning Strategies
This theme has two sub-themes, namely “peer-to-peer teaching and learning” and “collaborative note-taking and pamphlet writing”.
Peer-to-peer Teaching And Learning
The results of our study showed that some students, especially those who had the desire to learn socially, formed groups of friends to facilitate their learning, and after dividing the topics among each team member and achieving mastery over the specified topics, they would teach each other. The use of this strategy led to reduced student workload and better learning owing to the division of responsibilities and the comprehensibility of peer explanations.
“Sometimes it was even like each of us would, for example, teach one chapter to the others. For example, if we had five chapters and there were five of us in a group, then each one of us would take one chapter. Well, this way, the work was divided among everyone. On the other hand, because each of the chapters we were responsible for was read very well, when we taught it, it was comprehensible to others.” (Participant 6, 7th semester female student)
Collaborative Note-taking And Pamphlet Writing
Collaborative note-taking and pamphlet writing was another collaborative strategy employed by the students. The final product of this strategy was a complete and concise educational pamphlet, which significantly reduced the students’ workload and made it easier for them to study for the final exams.
“We had a note-taking and pamphlet writing group, and we had a class representative for note-taking and pamphlet writing. This representative would divide the class into smaller groups, and each group was responsible for a certain topic, which had to be written down based on that teacher’s voice and PowerPoint [slides], and then finally the representative would combine all these pamphlets and put them in the pamphlet group. This note-taking and pamphlet writing was very good because the contents were complete, and it was much easier to read at the night before the exam.” (Participant 9, 8th semester female student)
Theme 3: Remaining Passive
This theme involves two sub-themes, namely “Giving up” and “Not taking action”. The results of our study showed that some students felt lost in the face of the challenges of e-learning and did not take effective action to help their learning.
“I didn't do anything special. The amount of material was so large that one would get confused. I would just read some topics the night before the exam only to pass the exam. It was really bad. I would keep praying that the in-person education would resume as soon as possible.” (Participant 11, 6th semester male student)