Journal of Clinical and Diagnostic Research. 2022 Oct, Vol-16(10): LC29-LC33 29 29 DOI: 10.7860/JCDR/2022/58107.17050 Original Article Nursing Section A Multisite Survey of E-learning Readiness and Academic Performance among Nursing Students in Saudi Arabia INTRODUCTION Electronic learning (e-learning) has become an effective educational delivery method over the past two decades. This strategy is a useful tool for enhancing teaching and learning quality, thus improving academic performance [1]. The benefits of e-learning include increased accessibility of information, interactive learning, innovative teaching, self directed learning, enhanced data searches via hyperlinks, availability of help when needed, promotion of internet use, and building responsibility and self confidence [2,3]. It is also cost effective for organisations that adopt e-learning by reducing operation costs [4]. Although e-learning has become increasingly common in nursing education, the extent of its use varies across programs and countries [3,5]. In Saudi Arabia, for example, the government has promoted the use of technology in many aspects, including education, as one of the main objectives for the National Transformational Program, ‘Vision 2030’ [6]. The use of e-learning among Saudi students might help enhance their academic performance. A number of researchers surveyed students to assess their perceptions toward e-learning in nursing education. Ramos- Morcillo AJ et al., conducted a study on nursing students from two public Spanish universities and discovered that they were hesitant to use e-learning [7]. Another study in Philippines found that nursing students lacked computer literacy and had negative attitudes about e-learning [8]. Since the shift to e-learning may complicate students’ learning, assessing students’ readiness to use e-learning would contribute to a rich education in academic contexts [1]. Further, it may be simple to deliver remote nursing information, but teaching necessary nursing skills online might be more complex. Previous researchers have also looked into the impact of face-to-face and blended learning on nursing students’ academic achievement [9,10]. In a quasi-experimental study, the researchers assessed the influence of blended learning (hybrid e-learning with face-to-face) on the academic performance of nursing students [10]. There was a substantial difference between the experimental and control groups, implying that e-learning improves students’ academic performance. However, because their sample was limited to individuals enrolled in a one-semester course, the generalisability of their findings may be limited. In another study, the researchers surveyed nursing students and concluded that nursing students believed that practical skills were best learned in practical settings [11]. Implementing e-learning may be difficult since it can be influenced by students’ readiness to use it, e-content accessibility, previous e-learning experience, and learners’ learning styles [12,13]. Learners’ attitudes toward e-learning can influence their willingness to use it [1]. Students also need to be mentally and physically prepared to participate in online classes and achieve better performance. Determining students’ readiness for e-learning is critical to implementing more effective education and performance. Research on such area in Saudi Arabia is lacking, which could lead to ineffective use of e-learning in nursing education. Thus, this study was conducted to determine factors associated with students’ academic performance. MATERIALS AND METHODS A cross-sectional, multisite study was conducted on undergraduate and graduate nursing students attending different nursing programs in Saudi Arabia. The data were collected between May and August 2020. In Saudi Arabia, there are two types of education supervised by the Ministry of Education: public and private. The government subsidizes public education and students are entitled to free access to a variety of electronic applications used in education. In private education programs, however, most services, including ADNAN INNAB 1 , NAJI ALQAHTANI 2 , GHAREEB BAHARI 3 , ALKADI ALSHAMMARI 4 , ALI KERARI 5 , MOHAMMAD K ALHARBI 6 Keywords: Education, Experience, Technology, Virtual learning ABSTRACT Introduction: Determining students’ readiness for e-learning is critical to implementing more effective education and performance. Nursing education in Saudi Arabia continues to struggle with a shortage of technical tools to enable teaching and acquiring critical nursing skills. Aim: To assess the level of e-learning readiness and academic performance and their association in nursing students and to determine the factors associated with e-learning readiness and academic performance. Materials and Methods: A cross-sectional, multisite study was conducted on a convenience sample of nursing students (N = 139) attending nursing programs from multiple public and private universities in Saudi Arabia. A structured questionnaire was used for data collection from May 2020 to August 2020. Multivariate analyses were run using Statistical Package for Social Sciences (SPSS). Results: The mean age of the study participants was 27.3±6.34 years. The total average of e-learning readiness was 4.16 (SD=0.54). Bivariate analyses showed that age was associated with both e-learning readiness (r=0.175, p=0.03) and academic performance (r=0.341, p<0.001). Employment status, level of education, and previous experience with e-learning displayed significant association with e-learning readiness (p<0.05). In multivariate analyses, only previous experience with e-learning had positively influence on students e-learning readiness (b=0.188, p<0.05). Technology access subscale (b=0.206, p<0.05) and level of education (b=0.323, p<0.05) had both positive impacts on students’ academic performance. Conclusion: The e-learning readiness score was high among the nursing students, especially if they were employed or had previous experience with it. Access to technology improved students’ academic performance. The current e-learning mechanism may need some developments in order to meet students’ different needs.