Restructuring education activities for full online learning:

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Twenty-two nursing students participated in the study. In the expression of interest form, most participants comfortable with any methods or prefer focus group discussion, except one from Year 3 and two (out of three) from Year 4 prefer an in-depth interview. After discussions with the prospective participants, the agreement resulted in four focus group discussions and three in-depth interviews. In specific, Year 1 has two focus group discussions (Group A: n=5; Group B: n=4), Year 2 has one focus group discussion (n=5), Year 3 has one focus group discussion (n=5), and Year 4 has three in-depth interviews (n=3). One participant from Year 1 Group A withdrew at the early stage of the study due being uncomfortable with the topic. The demographic information of the completed participants is shown in Table 2. The time required was 37 minutes for FGD-1, 43 minutes for FGD-2, one-hour-and-six-minutes for FGD-3, and 54 minutes for FGD-4. Meanwhile, the in-depth interview required 21 minutes (IDI-1), 18 minutes (IDI-2), and 20 minutes (IDI-3), respectively. The majority (n=19/21, 90%) of the participants briefly responded that they agreed with the summary findings.

Table 2 Demographic Information of the Participants (N=21)

Three themes with ten sub-themes were generated, as illustrated in Fig. 1. As the sessions were conducted in pidgin or contained most of the Malay language, quotes were translated into English. Pseudonyms were used to maintain anonymity.

Fig. 1
figure 1

The inter-dependence of themes related to full online learning

Theme 1: Full online learning has ramifications on life

Under this theme, full online learning has been explored to impact beyond the education aspect. The effect encroaches into the participant’s personal life and worldview. It can be illustrated into four specific sub-themes.

It is about life

Education life is more than just studying. Participants considered student life is not just about attending the education programme and for academic learning only, it is part of gaining life experiences and developmental growth. The participants perceived that full online learning made them lose their university life, especially among the junior cohort. For example, this has been voiced by participants:

We were first informed that we can go [physically] to the university and can [physically] register at the university, but suddenly one week before that, it was cancelled. It is a bit of a disappointment as I was excited to experience how the [university] life is… like during the orientation, just online [orientation], so it does not feel like an orientation. It does not feel as it is supposed to be. It feels nothing, just like usual…” [Participant B, Year 1, FGD 2]

Like the seniors during their first year, they went to… like the hospital.. We, the first year, do not have that kind of experience yet. So, it is such a waste during this pandemic for our years.” [Participant D, Year 1, FGD 1]

Full online learning has retarded their social development and relationship with their peers. This makes trust among their classmates fragile and impacts their learning activity. For example, one participant mentioned:

Err… It is difficult to communicate and socialize, … especially when we are in the first year, just enter [to the university], so we do not know each other, never met, never see each other. Then, when we want to do assignments, it feels a bit of a challenge because we are not familiar with our group partner. So, we do not know the individual’s strength and weakness.” [Participant A, Year 1, FGD 2]

In contrast, participants in the senior years feel less impacted by social relationships with their peers. They had physically met and built rapport with their classmates before the pandemic struck.

…my social life remains the same, nothing changes” [Participant C, Year 3, FGD 4]

…we [friends, juniors-seniors] kept in contact. So, for me, it is less impacted”. The participants added, “Maybe for the first year, it is their first year, right, the first intake, the first semester, right? So, they have never been in college, never meet, so perhaps they are not familiar and lack in asking us questions or anything [communicate]… I think that it is…” [Participant A, Year 4, IDI 1].

The blurred division between education life and personal life

Full online learning has eliminated boundaries and a sense of territory in an individual’s perception, namely personal role, spatial, and time. During the COVID-19 lockdown, there is a phase where the students need to return to their homes and learn remotely. At the same time, there is another phase where the students are allowed to return to campus but remain only in the hostel while still learning via online. Lack of separation was noted, especially when learning from home.

Before this, we know if stay at home, is a place for us to relax, umm… to sleep, all that right. However, now, we need to work from home, everything at home.” [Participant B, Year 3, FGD 4]

Because when we are online… we… umm… we are also a child at home, so we need to help do the house chores, all the other things. So, we need to divide our tasks more.” [Participant A, Year 1, FGD 1]

Non-conducive environment for learning

Online learning creates a non-conducive environment compared to traditional brick-and-mortar class attendance for teaching and learning either for the students or the educator as notified by the participants. There are many challenges and disturbances available. A proper environment such as a college or dorm is more conducive for learning, contributing to feel as a student than at home.

…when we at college, we have the surrounding that facilitates us as a student. So, when I am at home, the environment is different; as a daughter, as a sister, we have many responsibilities.” [Participant A, Year 4, IDI 1]

…sometimes, I [attend] the class in the car. It is one of the disturbances.” [Participant C, Year 3, FGD 4]

…we do not have the equipment at home. Like physical learning, we go to the university; there is a facility, everything is there, that is one thing. Like, okay, for example, if we use of what we have at home, the feeling is different.” [Participant C, Year 2, FGD 3]

…the lecturer is also at home. So, they also do not have the equipment to show us, to demonstrate to us. So, they use many videos to show during the class. However, that is still constricted.” [Participant B, Year 2, FGD 3]

“…the equipment that we need to use, we do not have it, and we cannot practice by ourselves at home. If we want to buy it, it is expensive. So, what we learned is just theory, like the theory of how to take blood pressure. Just a theory as we cannot do the hands-on practice. So, it is difficult. Just theory without skills.” [Participant A, Year 1, FGD 1]

Health and well being

Most participants voiced that they feel exhausted with online learning. Some of the participants felt stressed and bored with the current condition. The exhaustion is manifested into a physical status where the participants feel a lack of energy, tired and rapid energy drained by attending the online learning all day. Online learning makes the participants lose physical activity opportunities and increases their sedentary lifestyle, even when compared with physical learning:

[in physical learning] always moving around, like going to the class and move to another class, Umm… but for me, the online learning is more tiring because we just stay at one place and focus on the computer, and then I feel like our eyes sore.” [Participant C, Year 1, FGD 2]

There are also complaints of physical health issues among the participants, such as vision problems and headaches:

…before the [full] online class, my eye problem is not so bad. However, now, my eye is more than 100 [myopia reading] where before this it was just 50 [myopia reading] like that…” [Participant C, Year 3, FGD 4]

Like me, because I have migraine, because, err… always look at the computer. It makes me have a headache, like many days I have been having a migraine, like that…” [Participant B, Year 3, FGD 4]

However, a participant considers that full online learning is a reasonable and proactive effort to protect them from the exposure risk of the COVID-19 pandemic.

…as we know, right now is the [COVID-19] pandemic. So… when we do online learning, at the same time we can take care of ourselves, our health [from exposed to the risk of COVID-19 infection].” [Participant A, Year 4, IDI 1]

Human is an adaptable being while the transition takes time

The participants prefer traditional physical learning more than full online learning. However the participants is becoming more open and receptive to the notion of online learning as part of standard mainstream practice. They can continue with the online learning if needed. Not only students but educators are more adaptable to online learning after the period.

…because there is [almost] two years with online learning. So, quite okay. Nothing weird. Umm… for me, everything is okay now. Like the lecturer also can adapt.” [Participant B, Year 4, IDI 2]

The participants prefer for some classes to be online such as those related to theory learning (i.e., cognitive) while requesting for physical learning for any topic that requires skill training – not only the practical (i.e., psychomotor) but also soft skills (i.e., affective).

…if for the online, like theory learning is okay. If face-to-face [physical] maybe something that we need to demonstrate… umm… procedure that we need to do.” [Participant C, Year 4, IDI 3]

Theme 2: Full online learning is a medium of teaching and learning delivery but with several concerns

The participants consider online learning as an alternative for delivering a lecture and learning activities; online learning is not a unique learning technique or approach. Therefore, many learning approaches in physical learning are transferable to online learning with some modifications. However, online learning partially brings the values and meaningful experience reflected in physical learning. The participants perceived that physical and online learning has its strength and limitation.

The boon and bane of fully online learning

A fine line that divides between the advantages and disadvantages of online learning. Several aspects were identified, such as flexibility in time, setting and activity, communication aspect, availability of back-up material (i.e., recording), financial concern, and participation in assessment.

The participants reported that full online learning had provided them and the educator with flexibility in time, setting, and activity. The flexibility provides an opportunity for the participants to be independent. The class can no longer be made during the day or hassle to reschedule due to lecturer unavailability (such as finding an empty slot or booking the facility). However, it can conveniently be made available at any time, even at night. It also saves time for the participants where minimal effort requires self-care and travelling. Moreover, online learning makes them able to attend the class whenever possible. In addition, the students can do other activities while attending the lecture, such as having a meal or doing house chores.

[The] good point is, we do not have to be there. We can even [attend the class] in the car. I saw some of my friends do that.” [Participant C, Year 2, FGD 3]

However, the flexibility given too much freedom has created uncertainty in scheduling and interrupting participants’ time. The participants may compromise on class attendance, such as near-missed incidents of non-attendance. The facility issues such as internet connection may require them to find a place such as a kitchen or uncomfortable corner of the house . There is also a misperception among some educators or family members who underestimate students’ burden and availability.

However, in the flexibility, sometimes it is too flexible until it disturbs our rest time… I have experience attending the exam at night.” [Participant C, Year 2, FGD 3]

Communication has become more feasible where the participants can communicate with their classmates using teleconference medium without requiring a place to meet. Communication can be done through various telecommunication methods such as WhatsApp or Telegram. This is not limited to their peers but also to the educators, whom they can email any queries they have rather than immediately meet the educator after the class finish when in traditional physical learning.

Online for me is easier to meet. Even though we cannot do work physically, the communication is easier, like we want to interact just via Google Meet” [Participant B, Year 3, FGD 4]

…but then on the online learning as we can only rely on the WhatsApp, or maybe a google docs, something like that to share information.” [Participant D, Year 1, FGD 2]

However, communication using technology has limitations where delay in response is tangible, feels a bit difficult in manoeuvring the technology (e.g., extended typing), missing the intangible message (i.e., non-verbal communication), and lack of authentic relationship (communicated for the sake of work and facts, rather than social mingling). Some participants prefer the conventional communication style of a face-to-face meeting.

Right now, we are in the online class, so if we want to ask or chat with our friends, we need to WhatsApp. I am quite lazy to type to… umm… ask my friends. I prefer to meet and directly ask, easier because what we want to know can get it on the spot. So if through WhatsApp, we need to wait for the person. Perhaps the person is doing something else whatsoever, so, after a long wait, like what we want to ask has… is no longer interested.” [Participant B, Year 2, FGD 3]

Most of the participants feel that the availability of the class recording is beneficial for them to refer for any missed information and revision. They can return to the recording at their convenience. The recording can be a backup if an unwanted event occurs (i.e., lost internet connection, parents calling, doing chores). However, this also creates a latent attitude among the participants where they do not give full attention during the class as they know they can refer to the recordings. Some students admit that hearing the recording is a bit dull and makes them sleepy.

[D]uring the study week, I will watch back the lecture recordings, you know… Umm, sometimes I think if face-to-face, I do not have a recording. Like me, if I do not understand, I need to meet the lecturer back. However, with the recording [available], I can watch back and understand what I learned previously.” [Participant B, Year 1, FGD 2]

…Frankly speaking, I feel sleepy watching the recording; I rarely watched it… However, yeah, the recording is also valuable. For example, I can review back lectures of last semesters on statistics and now understand it better for my research project” [Participant B, Year 4, IDI 2]

Some participants perceived that online learning made them save more money and reduce cost-related expenses such as preparing the assignment materials. However, other costs may increase, such as the subscription to internet service and those students who do not have the proper equipment for learning need to find a way to get the equipment such as laptops. Having proper information technology equipment (i.e., computer, laptop, smartphone) and facility (i.e., mobile data, Wi-Fi and internet connection) is crucial to ensure comfortable and successful online learning.

…for me, online learning also has its advantages. Like, save time, safe energy… oh yes, save money.” [Participant C, Year 1, FGD 1]

At first, I need to share a laptop with my brother, because… err… I do not have my own laptop at that time. So, it is quite difficult; for example, I have a class that clashes with my brother’s class. Then, I knew that Zoom could be installed on the phone. So, I just use the phone afterward. Hmm…” [Participant B, Year 1, FGD 1]

…students do not have much money. So, difficult to pay… like buying the internet plan…” [Participant D, Year 1, FGD 1]

The students presume that online learning has created liberty in their assessment and makes them more prepared to achieve a better grade. However, some participants consider this has increased the burden on preparing the assignment. In addition, assessment, especially examination conducted online, creates conflict and queries the students’ integrity and ethics when approaching the assessments.

…and, even sometimes, we… like… Umm… we prepare the script earlier. So, it is easy for our presentation.” [Participant A, Year 2, FGD 3]

…mostly… [the assignments] need to do video. So, personally, it is one of the biggest constraints for me to do the assignment. It feels like… to prepare, okay, whom we want to make patient, and then the equipment, where to do it. And then, it is not just about shooting the video only. It’s like we need to watch back; if not okay… then we need to re-shoot.” [Participant B, Year 2, FGD 3]

Final exam right, umm… each subject… each course, like, different. Like ours, we need to answer at that time and open the camera [for proctoring]. So, there are other courses I saw, like the lecturer gave them the whole day and it is up to them, they can discuss with friends, seek answers, etc. Umm… so, it is sort of unfair. It is not standardized.” [Participant A, Year 3, FGD 4]

However, the participants consider that all these depend on the individuals to decide how they utilize online learning to scaffold its benefits or drown into its affliction.

Challenges associated with full online learning

However, online learning identified several challenges, such as a shorter attention span. The participants deemed that they were easily distracted and jeopardized their technical skills.

[F]rom what I observe, in an online class, I can focus only 20 to 30 minutes, and after that, even I try to focus, it will be challenging. When the lecturer says [the lecture], I just see and hear but cannot understand what the lecturer says. If compared to a physical class, I can maintain my focus for one to one-and-a-half hours… like that.” [Participant C, Year 3, FGD 4]

One significant barrier to full online learning is that it only caters mainly to cognitive purposes, while limited for affective and negligible for developing psychomotor skills . The participants affirmed that the nursing course is technical and requires skill development. However, the full online learning is inadequate to train their nursing skills, especially the new skills. In addition, there are contradictions found between the procedure taught as it uses commercially and publicly available video, which may not be similar or inapplicable in actual local clinical practice. Thus, the participants feel they need to re-learn, which has taken more of their time.

Like before, , we practice in the nursing lab after the theory. Nevertheless, [in online learning] when we finish with the theory, it just ends. It is difficult for us to understand things when watching a video because it is a skill, right. It cannot be like that; when we learn a theory, we can memorize all that; however, when it is a skill, yes, we can memorize, but it is gone when we want to do it. Because it is experiencing, based on experience.” [Participant B, Year 3, FGD 4]

Not only that, the participants perceived that their obtained skills were also deteriorating. This is because they have limited opportunities to practice the skills again.

…one more, our existing skills are also diminishing. For example, we are now at the senior year, so when we are not going towards, or going to the nursing lab for practice whatever we learned and have done, we like… not remember it [skills]” [Participant E, Year 2, FGD 3]

Coping strategy in handling full online learning

The participants reported several strategies to stay alert and sustain their online learning participation and independent learning.

for online [learning], make sure, if do not have Wi-Fi, then buy the internet data, all that to smoothly join the class, as worries being disturbed due to connection problem. Like if do not have room (for study), try to find a place like in the kitchen, far from others, to focus on the class.” [Participant B, Year 3, FGD 4]

For staying alert and sustain their participation in fully online learning, especially the lecture, the participants implement small interval activities for a quick divert and refresh. The participants may move around, do other activities, or have a small meal when they feel tired or uncomfortable.

…like before the class, I will prepare snacks or something to eat… Umm… during the class. So, I can focus because it is difficult when hungry.” [Participant D, Year 3, FGD 4]

For me, I will play with the handphone, or otherwise, I lie down, go to the toilet, have a drink, walk a bit, then sit back in front of the computer.” [Participant D, Year 1, FGD 1]

For their independent study, the participants modified the usual learning approach they had done before online such as group discussion that was previously conducted by meeting outside and gathering in a group physically into meeting virtually via teleconference application.

Theme 3: Foundation in teaching and learning is the key

Techniques or strategies in teaching and learning play a pivotal element to ensure the continuity and sustainability of learning. The techniques are general, and not limited to only technology but emphasize educational theories, individual approaches and the conventional concept of teaching.

Role of the educator

In participants’ opinions, educators need to excite the teaching by avoiding being monotonous in the lecture, not just reading the slide, and applying various activities to make the learning session interactive and engaging.

…like some of the lecturers, ermm… that just read the slides, as I said before, and then did not give any explanation. Maybe s/he include all the… all-important points in the slide. We can say that, and then each part s/he just read-only. *laughing*. ermm… I think, ermm… this one also let us feel bored. We do not want to just listen, and go through the slide. Because aaa… if the lecturer just read the slide, we can also read [it] by ourselves.” [Participant A, Year 1, FGD 2]

…I think that s/he teaches with enthusiasm. Before s/he teaches something, s/he will relate the thing with… current… general issue. So, it makes me like, ‘Wow!’ so interesting on how s/he teaches. S/he likes so eager to make the students understand on what s/he tries to deliver.” [Participant B, Year 1, FGD 2]

The participants mentioned that they less appreciate total independent learning, such as replacing the lecture with activity and presentation without validating the information presented. As they feel uncertain about the information they gain and less confident about what they learn, the participants require confirmation from the educator.

[A lecturer] likes to replace, right. Sometimes, s/he just replaces the class with lots of assignments.” [Participant E, Year 3, FGD 4]

In addition, participants appreciate educators who are empathetic and not condemning. The participants appreciate educators who are enthusiastic about teaching and if the procedure is carried out by the educator rather than showing a video from the internet.

…more empathetic. Like, sometimes a student says coming a bit late due to an internet problem, please do not respond like “Oh, you can prepare early”. The internet, sometimes is beyond our control. Hmm… I found lots of lecturers like that. I feel like they lack empathy. It actually will affect the student’s emotion.” [Participant C, Year 2, FGD 3]

…some likes condemning, like, err… s/he said, “I have told you to study by yourself, right? I have given a task for you to do… to look at” like that. Furthermore, like mad at the students because we cannot answer his/her question. It is not because we do not want to answer the question (correctly), but we do not understand.” [Participant A, Year 1, FGD 1]

Maybe lecturer or the department can do… or request the clinical instructor or anybody to… err… record a procedure video for us to watch. Because when we watched the procedure video on YouTube… err… yes, it can add our knowledge, but the procedure is clashed (not suitable) with the standard checklist we have.” [Participant D, Year 2, FGD 3]

The participants believe that the educators can improve themselves by having training related to technology use and technology-based learning applications.

Both (students and educators) need… urm… training or courses to improve online learning and teaching skills. Because not all lecturers know how to use this online [learning], even though they have been for a year like this. There are many things to explore, a lot… material, apps, websites that can be used for teaching purposes to make our learning more interesting. Moreover, for the students, we would like to improve our note-taking skills.” [Participant C, Year 3, FGD 4]

Teaching and learning approaches

Although the participants believe that asynchronous learning, such as lecture recording, is beneficial for them, the participants more appreciate synchronous than asynchronous learning. The participants feel synchronous learning is more meaningful and has a ‘soul’ of teaching and learning than asynchronous, which feels ‘disconnected’.

Although the online class has recorded lectures, respect for the lecturer is important for me. So, I still attend the online (synchronous) class. I feel it is better to attend the class than not coming and just watching the recording.” [Participant D, Year 2, FGD 3]

The participants seemed to appreciate activities while still expecting guided learning to validate the acquired knowledge. The participants identified that a non-marking quiz is beneficial to help them immediately revise, focus on the lecture to prepare for the quiz, and understand what is important in the lectured topic. The participants request all-participate quiz activities such as using game applications; the participants are uncomfortable with individual-calling question-answer activity.

…some lecturers have done… Umm… Q&A (quiz) session but not directly to a particular student, but instead s/he used KahootTM (quiz game application), so all students can join. Sometimes some students are shy to answer (direct asking), but with KahootTM, everybody participates, knows right and wrong (answer) simultaneously.” [Participant D, Year 3, FGD 4]

A simple group activity in the middle of the class is another approach highlighted by the participants. The group activity is perceived as helping break the dull pattern in online learning while making them more active. However, the educator needs to be wise in allocating ample time, not a complex task, conducive and non-threatening environment, and a supportive attitude with immediate constructive feedback.

…like a way of one lecturer to maintain us energetic until the end of the class. Where s/he always gives us a small task, group work just around 10–20 minutes for a short presentation. So, we feel refreshed and focused.” [Participant D, Year 2, FGD 3]

Excessive information in lectures makes the participants feel overwhelmed and unable to absorb the information thoroughly. The participants hope that the educator may point out which information is critical. A gap between each topic is required to help the students relax and rehearse the information. The participants believe that various teaching approaches implemented during online learning are helpful for them to stay alert. However, the implementation should be nice, not too crowded and, confusing. This includes using uncrowded PowerPoint slides, interactive slide preparation, video, simple reading materials, and demonstration.

the lecturer cannot like include everything into the slides…” [Participant D, Year 1, FGD 2]

I like with a technique that is not straight lecture, like if the class is two hours, then that two hours is a lecture. I prefer, some of the lecturers that lecture like one hour, then have gaps to watch the video, do discussions, gave questions, and asking for our opinions about the video.” [Participant B, Year 3, FGD 4]

Skills learning are the most impaired due to fully online learning. The students hope that the lecturer can replace the skill teaching using other methods. Utilizing sophisticated technology such as virtual simulation can be explored, which provides richer haptic feedback.

It is like this; it is like the Labster (i.e., virtual lab online webpage), make a simulation program. So, like, they make you feel like you are in the lab like you can pick up the test tubes and insert all the kinds of solutions. It is a simulation program, so like you have the interactive lab. It is like, you feel like you’re in the lab. So compared to that, I think that’s more interactive comparing to like just watching a video, a practical video it’s like watching somebody do like all those things, like compared to that I am more like to have an interactive simulations program, for me to try things out instead of just watching videos, yeah.” [Participant D, Year 1, FGD 2]

The participants appreciate prepared educators, such as providing the lecture slide early, the assignments early, and informing on any schedule change early. The participants find it difficult if the schedule, either class or test made abruptly or unexpectedly.

The lecturer does not give the notes early. So, in consequence, we are rushing to jot down the notes. If the lecturer gives us the notes early, we can refer to it and just note down any important points during the lecture.” [Participant E, Year 1, FGD 1]

Pressure from the lecturers who like… umm… like to give lots of assignments, sometimes as they wish, change the class at the time they want, and suddenly have a test.” [Participant C, Year 3, FGD 4]

Motivation and regulation

Some participants had no issue with online learning, especially those in their most senior year. However, several participants feel stressed, and others are demotivated with full online learning. The participants continue with the online learning is not because of the online learning itself but driven by other factors such as their willingness to learn, thinking about the future, wanting to deliver the best for patients, finishing the study, maintaining academic achievement, achieving ambition, family, friends support, financial, and respecting the educator.

…what drives me is my family and my future.” [Participant A, Year 3, FGD 4]

…I just want to pay my [study] loan after I finish my study. I have studied right.” [Participant E, Year 3, FGD 4]

…I do not have any motivation for this online learning. However, I have to learn online because I do not want to fail…” [Participant C, Year 1, FGD 2]

…my motivation is from our… my surroundings and my friends because all my friends also study online and then, ermm… So, I want to follow them, I don’t want to isolate myself.” [Participant A, Year 1, FGD 2]

The participants implement several approaches to self-regulate their learning. Some participants do early preparation before attending the online class. Other participants consider group discussion as beneficial for helping in their learning. Some other participants have the initiative to contact the educator for further learning and clarification.

…we cannot procrastinate because if we do, then the assignments will be piled up. So, every day we attend the class, we [also] need to study the subject of the day immediately, we cannot just leave like that. Like, if something we do not understand, we cannot delay, then near to the exam will study back. No, I cannot. We need to make notes immediately. Hmm… Because, if we wait until the final exam… Uh, study week to start studying, we cannot, because too many subjects. Furthermore, the time during the study week is not enough.” [Participant A, Year 1, FGD 1]

I will study early, quite early. Like after the class, I will re-watch the recording or revise my note. Hmm… If I do not understand anything, I will… message the lecturer.” [Participant E, Year 1, FGD 1]

We did group discussions on a certain topic, like who do not understand [can] learn together.” [Participant B, Year 2, FGD 3]

Most of the participants believe that it is up to one’s initiative and individual responsibility to ensure successful participation in learning. Self-determination, such as self-care, preparing the equipment for learning early, ensuring a good internet connection, and preparing an environment conducive to learning, helps to make their learning smoother and hassle-free. In addition, the participants consider time management is an essential skill for them to go through online learning. The participants hope there is also training available for them in time management related to online learning, such as note-taking skills and assignment preparation, and training available on team working in online learning.

…for me, it [online learning] disciplining myself, and teach me to appreciate the time.” [Participant A, Year 4, IDI 1]

…we need to have… umm… a training on time management, for students. And then… one more is about teamwork.” [Participant A, Year 4, IDI 1]

The findings reported above were synthesized to develop a framework guiding educators to escalate a better education practice. The practice framework integrates learning approaches and educator qualities for a single lecture or class activity. The practice framework is shown in Fig. 2. The practice framework is a systematic organization of learning activities to ensure an exciting learning environment with active engagement of the students in the learning process and good educator participation and preparation for teaching. The practice framework considers for health and well-being of the learners, and healthy behaviour is also incorporated. However, the framework is flexible, especially on the activities during the lecture, where it should not be followed linear or prescriptively.

Fig. 2
figure 2

Practice framework developed from the qualitative findings

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