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Journal of Education and Practice
ISSN 2222-1735 (Paper) ISSN 2222-288X (Online)
Vol.4, No.26, 2013

www.iiste.org

Attitudes of Nursing and Midwifery School's student toward
Blended learning at Mazandaran University of Medical Sciences
Mohammadreza Neyestani
Assistant Professor, Faculty of Educational Sciences and Psychology, University of
Isfahan, Isfahan, Iran. E-mail: neyestani@gmail.com
Hasan Babri (Corresponding author)
MS student of, Educational planning, School of Educational Sciences and Psychology, University of Esfahan,
,Iran. E-mail: hasan.baabri@yahoo.com
Abstract
Blended Learning is an educational method which has been used recently in higher education worldwide. This
study was conducted to investigate attitudes of the student of Nursing School at Mazandaran University of
Medical Sciences toward blended learning. The present study is a descriptive- cross sectional research. The
population included All students of Nursing and Midwifery Mazandaran University of Medical Sciences whom a
randomly stratified sample of 134 were selected. Also, Buket & Soylu (2008b) blended learning Attitude Scale
was used to measure attitude. Data were analyzed using descriptive indices.Results showed that, majority of the
respondents had positive attitude toward blended learning and Very small number of them had negative attitudes.
Also, there were no significant relationships between Varies (age and Gender) and the attitudes. So, According to
the positive attitude of the respondents toward blended learning, it is recommended that further studies take place
in order to design and implement the approach in formal education in the school of Nursing and Midwifery of
mazandaran University of Medical Science.
Key words: attitude, blended learning, student, School of Nursing and Midwifery
Introduction
Teachers concerned about the quality of learning in universities are facing a number of challenges related to
information and communication technologies (ICT)( Ginns & Ellis ,2006). Information and communication
technologies, which have been developing rapidly, have become one of the indispensable elements of the 21st
century. They have influenced, like all other fields, educational institutions which are the most important subinstitutions of the social structure. They have offered a favorable environment for the development and use of
various methods and tools (Buket & Soylu, 2006c).
In today’s world, information and communication technologies are influenced in many different areas
where people need more knowledge and better standards to accomplish their works. Education is one of these
fields that information and communication technologies are substantially interested in. Especially, education
needs innovations and new approaches to improve quality of educational studies (Hoic-Bozic, Vornar & Boticki,
2009). Thus, there is a considerable search for better education methods or techniques that are especially
supported with advanced technologies. In time, a remarkable improvement has been succeeded in education,
thanks to information and communication technologies. Many different methods, techniques and approaches
have been developed and implemented to realize requirements in educational studies (Kösea, 2010).
In recent years the spread of computer use, development of Internet technologies and fast Internet
connection have paved the way for providing a significant part of distance education through the Internet. That is
why, concepts such as e-learning, online learning or web-based learning, where Internet and network
technologies are overwhelmingly used in the presentation and reception of the content, are used to refer to these
learning environments rather than the concept of distance education which defines a quite larger area, including
models of learning through letter and radio broadcasting (Buket & Soylu, 2006c).
In spite of many advanced features of the online instructional mode, issues such as low levels of
interaction, lack of varied instructional strategies, and poor instructional design are often cited as shortcomings
when discussing the effectiveness of online instruction. Responding to these issues, many studies such as Oh,
Lim and French, (2004) and Oh and Albright (2004) have discussed the advantages and disadvantages of the
online instructional mode. Having acknowledged the disadvantages, advocates of online instruction have made
efforts to overcome them in many ways.
Some have claimed that online instruction restricts active student engagement in learning events unless
the student is a self-motivated, active learner. Rovai (2003) claims that online instruction is often found to be
“impersonal, superficial, misdirected, and potentially dehumanizing and depressing”, inhibiting the pedagogical
values of instruction. In addition, other studies (Daniels and Moore, 2000; Ford and Chen, 2000) expressed that
18
Journal of Education and Practice
ISSN 2222-1735 (Paper) ISSN 2222-288X (Online)
Vol.4, No.26, 2013

www.iiste.org

online learning environments require students to be strongly motivated and self-directed, and possess strong
organizational skills in their learning habits since working in online learning environments is an isolating and
independent job.
Considering the fact that sharing feelings, experiences, knowledge, and a sense of belonging (Valejs,
2003) is important in the learning process, online learning environments prevent both learners and instructors
from experiencing those sharing opportunities in dynamic communication environments. Therefore, strategies
have been suggested to improve online learning environments, and various instructional practices (e.g. blended
instruction, hybrid instruction) have been attempted.
Blended learning is treated as an instructional strategy, which is developed in a networked environment.
Such a strategy is usually supported by virtual learning environments (VLEs), which are a computer-based
standardized learning system and are used to sustain content delivery of online learning as well as to promote
online communication between an instructor and learners (Huang, Ma1,& Zhang, 2008).
Blended or hybrid learning is a wide-ranging term encompassing a range of different meanings. The
definitions of blended learning vary depending on delivery media, instructional methods, and type of instruction
(Graham, 2006). The most common and broadest definition is the emphasis on mixing types of instruction (i.e.,
traditional face-to-face instruction and online instruction; Graham, 2006; Rooney, 2003; Sands, 2002; Ward &
LaBranche, 2003; Young, 2002).
Graham (2006) summarizes three definitions of blended learning as the (a) combination of instructional
delivery media, (b) combination of instructional methods, and (c) combination of online and face-to-face
instruction. The first two definitions reflect the debate on instructional media versus instructional methods on
learning and are too broad to make blended learning a distinct phenomenon since virtually all learning systems
include a variety of methods and media.
Blended learning is premised on two key aspects: the effectiveness of the mix mode or multiple media
approach in terms of accessibility, and meeting students’ academic and non-academic needs. Blended learning
combines the benefits of online learning and face-to-face instructions. It takes the best qualities or features from
every delivery format, whether it is an online learning management system or a print- based correspondence
study. It provides greater access to course material in one delivery mode than is perhaps available in another
delivery mode.
So, Blended learning combines various models of traditional and distance education and makes use of all
types of technology, in other words it is a combination of conventional classroom instruction and e- learning.
Factors such as learners’ individual differences, personal characteristics, their opinions and learning styles have
significant impacts on a learning environment. For instance, the learners who have difficulty in establishing
communication in the classroom environment may find it easier to communicate in the electronic environment. It
is important, during the process of organizing blended learning environments, to establish the equilibrium
between face-to-face education and online environments, in view of the advantages of both methods (Buket &
Soylu, 2008).
Blended learning combines multiple delivery media that are designed to complement each other and
promote learning and application-learned behavior. Blended learning programs may include several forms of
learning tools, such as real-time virtual/ collaboration software, self-paced Web-based courses, electronic
performance support systems (EPSS) embedded within the job-task environment, and knowledge management
systems. Blended learning mixes various event-based activities, including face-to-face classrooms, live elearning, and self-paced learning. This often is a mix of traditional instructor-led training, synchronous online
conferencing or training, asynchronous self-paced study, and structured on-the-job training from an experienced
worker or mentor (Singh, 2003).
Blended learning is described by Thorne (2003) as “a way of meeting the challenges of tailoring learning
and development to the needs of individuals by integrating the innovative and technological advances offered by
online learning with the interaction and participation offered in the best of traditional learning” (Buket & Soylu,
2008a).
Blended learning environment which is regarded as a different type of distance education amalgamates
the advantages of distance education with the effective aspects of traditional education. In contrast to classical
learning environment which poses restrictions on place and time, e-learning provides an environment where the
learners can study regardless of time and place restrictions according to their learning speed. The factors such as
19
Journal of Education and Practice
ISSN 2222-1735 (Paper) ISSN 2222-288X (Online)
Vol.4, No.26, 2013

www.iiste.org

learners’ individual differences, personal characteristics and learning styles have significant impacts on the
learning environment. For instance, the learners who have difficulty in establishing communication in the
classroom environment find it easier to communicate in the electronic environment. As mentioned before, the
disadvantages of e-learning deriving from the interruption of socialization process and the weakening
attractiveness of e-learning applications in the eyes of learners are combined with relevant disadvantages of faceto-face education environments. It is obvious that the weaknesses and strengths of online environment and the
weaknesses and strengths of face-to-face education integrate in blended learning (Buket & Soylu, 2006c).
There are a number of potential advantages to blended learning that are emerging. Some of these revolve
around accessibility, pedagogical effectiveness, and course interaction. Many of today’s college students are
nontraditional, attempting to balance family, jobs, and university life. Coming to campus is often difficult for
many of them and through reducing the number of face-to-face hours required, blended learning can help them
meet this challenge. Universities and faculty are looking for ways to reach and retain these students (Dziuban,
Moskal & Hartman, 2004).
Blended learning has many advantages, which make it more popular among teachers and students. Some
of these advantages can be listed as below:
� By using combination of different education techniques and technologies, blended learning can
improve students’
academic achievements.
� Blended learning can be applied to students with different learning styles and levels.
� Blended learning allows cost savings and lowers general education expenses.
� Using various education techniques attracts more students’ attention to the course subject.
� By using combination of face to face education and other education techniques, students can be
allowed to access to knowledge from anywhere until they meet face to face with teachers(Kösea, 2010). In
today’s competitive environment, schools need to be fully cognizant of the views and feelings of their primary
stakeholders – the students. Given the fact that the students are at the centre of this process, it is imperative that
their views on their experiences be obtained before contemplating any shift from the traditional face-to-face
modality to blended learning (Kistow,2011). In the last decade, the blended learning approach has been adopted
widely in schools, universities and training sections in the business world. One of the major reasons this
approach is gaining momentum is due to teachers and instructors not using online learning to completely replace
traditional face to face classroom teaching, but to complement or overcome some of the short comings of face to
face teaching. In blended learning, instructors typically use computer technology with Internet access. The
blended learning environment may be as simple as providing administrative information, reading materials, and
resources for the students. However, some teachers and instructors enable students to interact with each other by
using asynchronous and synchronous communication technologies (Cheung & Hew,2011).
Nowadays, blended learning is one of the most advanced educational techniques. Considering the
commencement of adopting such modern teaching techniques across the world as well as in the Iranian
universities, one needs to apprehend the knowledge and attitude of students as one of the most important
components in the education system. Thus, this study was designed to investigate the knowledge and attitude of
students towards blended learning at Nursing Students at Mazandaran University of Medical Sciences.
Method
The present study is a descriptive- cross sectional research. The population included All students of Nursing and
Midwifery mazandaran University of Medical Sciences whom a randomly stratified sample of 134 were selected.
Also, Buket & Soylu (2008b) blended learning Attitude Scale was used to measure attitude. Data were analyzed
using descriptive indices.
Results
The response rate of the participants was 94 percent (127 students) of whom 68 percent were female and
32percent male. The participants ranged in age from 19 – 28.
Rate Attitudes of Nursing student toward Blended learning at mazandaran University of Medical Sciences, Be
seen in Table 1.

20
Journal of Education and Practice
ISSN 2222-1735 (Paper) ISSN 2222-288X (Online)
Vol.4, No.26, 2013

www.iiste.org

Table 1. Attitudes of Nursing student toward Blended learning
Items
Totally agree
I agree
Number (percent) Number (percent)
The Web environment helps me to follow courses easily
91(71/60)
34(26/77)

Disagree
Number (percent)
2(1/57)

Whenever I need help in the web environment I can get it

88(69/29)

38(29/92)

1(0/78)

I can reach the web environment wherever I want

76(59/84)

47(37)

4(3/14)

The interaction in the web environment is quite enough for
me
The announcement section is prepared quite well
The Web site is comprehensible
I find the web site quite clear
I can use the forum easily
I can find the answers to questions provided in the Forum
environment
I can share my thoughts and experiences with my friends
in the Forum environment
Teaching staff give feedback through forum environment
The forum is supportive and helps me reinforce what I
have learned
I find that communication and mentoring in the forum
environment are quite enough
Modules in the web environment are quite comprehensive
including all achievements
Achievements in all modules are always defined clearly
Learning and teaching activities in all modules are always
defined clearly
Modules in the web environment meet my needs
The explanation of the subject help me to learn the subject
Worksheets help me to understand what I have learned
References and narration met my needs
Length and presentation of the subject help me to follow
the subject easily
The teacher completes missing subjects during the face to
face sessions
Generally, I can find the answers to my questions during
the face to face sessions
I can find the answers to my questions during the face to
face sessions
Face to face sessions help me to learn about subjects in
detail
Sharing and discussion environment in face to face
sessions are quite good
It would be better if teachers explained the subject during
the face to face sessions
Face to face interaction is quite useful for understanding
the subject much better
Face to face environment with gestures and mime is quite
effective
Face to face interaction helps me to learn better and assists
in the retention of information about the subject

112(88/18)

12(9/44)

3(2/36)

64(50/39)
55(43/3)
41(32/28)
98(77/16)
54(42/51)

56(44/09)
66(51/96)
78(61/41)
27(21/25)
59(46/45)

7(5/51)
6(4/72)
8(6/29)
2(1/57)
14(11/02)

56(44/09)

62(48/81)

9(7/08)

73(57/48)
92(72/44)

46(36/22)
31(24/4)

8(6/29)
4(3/14)

70(55/11)

55(43/3)

2(1/57)

61(48/03)

55(43/3)

11(8/66)

42(33/07)
38(29/92)

71(55/9)
76(59/84)

14(11/02)
13(10/23)

93(73/22)
51(40/15)
87(68/5)
88(69/29)
58(45/66)

29(22/83)
68(53/54)
37(29/13)
35(27/55)
68(53/54)

5(3/93)
8(6/29)
3(2/36)
4(3/14)
1(0/78)

118(92/91)

9(7/08)

0

72(56/69)

50(39/37)

5(3/93)

68(53/54)

48(37/79)

11(8/66)

70(55/11)

54(42/51)

3(2/36)

67(52/75)

51(40/15)

9(7/08)

71(55/9)

54(42/51)

2(1/57)

49(38/58)

66(51/96)

12(9/44)

95(74/8)

28(22/04)

4(3/14)

52(40/94)

67(52/75)

8(6/29)

21
Journal of Education and Practice
ISSN 2222-1735 (Paper) ISSN 2222-288X (Online)
Vol.4, No.26, 2013

www.iiste.org

If something went wrong in web environment, we would
need face to face interaction to make things clear
Evaluation criteria in the web environment guide us in
how and what to do in our projects
Mentoring about the projects help us a lot and makes the
Project easy for us
Evaluation criteria is clear and understandable
Interval assessments during face to face sessions help us to
complete the projects easily
To learn through website makes me responsible for the
course and motivates me to attend the course
To learn the subject through the web site is much more
interesting than other methods
My motivation is very low while I am studying on the web
It is very new and different way to study on the web
It is very difficult to study on the web for me
To come the class with the preparation helps my learning a
lot
I believe that this is a very effective system
I can study by myself in a more comfortably and in a quiet
environment
This method is easier for me
To study on the web help me make plans
I can study at my own pace
I get bored when I am studying on the web
I find the forum environment very boring
The Web environment helps us prepare for the course
I can study over and over again in the web environment
Total(percent)

97(76/37)

27(21/25)

3(2/36)

49(38/85)

70(55/11)

8(6/29)

119(93/7)

8(6/29)

0

71(55/9)
107(84/25)

39(30/7)
20(15/74)

17(13/38)
0

41(32/28)

67(52/75)

19(14/96)

85(66/92)

33(25/98)

9(7/08)

67(52/75)
104(81/89)
80(62/99)
117(92/12)

49(38/58)
23(18/11)
41(32/28)
10(7/87)

11(8/66)
0
6(4/72)
0

51(40/15)
83(65/35)

62(48/81)
41(32/28)

14(11/02)
3(2/36)

114(89/76)
54(42/51)
98(77/16)
48(37/79)
60(47/24)
101(79/52)
60(47/24)

12(9/44)
65(51/18)
29(22/83)
77(60/62)
57(44/88)
26(20/47)
63(49/6)

1(0/78)
8(6/29)
0
2(1/57)
10(7/78)
0
4(3/14)

59/14

36/29

4/57

According to Table 1- The majority of the respondents had (59/14) percent had completely positive attitude,
(36/29) percent had positive attitude toward blended learning; and Small number of respondents (4/57) percent
of them had negative attitudes.
Also, statistical analysis showed that there were no significant relationships between Varies (age and Gender)
and the attitudes.
Conclusion
blended learning is one of the most advanced educational techniques. Considering the commencement of
adopting such modern teaching techniques across the world as well as in the Iranian universities, one needs to
apprehend the knowledge and attitude of students as one of the most important components in the education
system. Thus, this study was designed to investigate the knowledge and attitude of students towards blended
learning at Nursing Students at Mazandaran University of Medical Sciences.
Results showed that (59/14) percent Respondents Said Completely agree with blended learning and (36/29)
percent Respondents Said Agree with blended learning , that According to these findings Can be concluded that
majority of the respondents had positive attitude toward blended learning. Also, statistical analysis showed that
There was no significant relationships between Varies age and the attitudes.
Because the blended e-learning uses benefits of both e-learning & face to face learning and provides more
flexibility and satisfaction for learner and teacher, it can be considered as an effective alternative method for
education in universities of medical sciences in Iran. So, According to the positive attitude of the respondents
toward blended learning, it is recommended that further studies take place in order to design and implement the
approach in formal education in the school of Nursing and Midwifery of mazandaran University of Medical
Science.

22
Journal of Education and Practice
ISSN 2222-1735 (Paper) ISSN 2222-288X (Online)
Vol.4, No.26, 2013

www.iiste.org

References
Buket, A, & Soylu, M. Y. (2008a). A Study of Student’s Perceptions in a Blended Learning Environment Based
on Different Learning Styles. Educational Technology & Society, 11 (1), 183-193.
Buket, A, Soylu, M, Y (2008b). Development of a scale on learners' views on blended learning and its
implementation process. Internet and Higher Education 11. 26–32.
Buket, A. Soylu M Y. (2006c) A Study on Students’ Views On Blended Learning Environment. Turkish Online
Journal of Distance Education.3(3) 7.
Cheung, W,S. and Hew, K,F(2011). Design and evaluation of two blended learning approaches: Lessons
learned. Australasian Journal of Educational Technology 27(Special issue, 8), 1319-1337.
Dziuban,CH. Moskal,P. and Hartman,J(2004). HIGHER EDUCATION, BLENDED LEARNING AND THE
GENERATIONS: KNOWLEDGE IS POWERNO .MORE Research Initiative for Teaching Effectiveness,
LIB 118University of Central Florida.
Ginns, P. Ellis, R.(2007). Quality in blended learning: Exploring the relationships between on-line and face-toface teaching and learning The Institute for Teaching and Learning. Internet and Higher Education (10) 53–
64.
Huang,R. Ma1,D. and Zhang,H (2008). Towards a Design Theory of Blended Learning Curriculum. ICHL '08
Proceedings of the 1st international conference on Hybrid Learning and Education.(3), 66 – 78.
Kistow, B(2011).Blended learning in higher education: A study of a graduate school of business, Trinidad and
Tobago Arthur Lok Jack Graduate School of Business, The University of the West Indies, St. Caribbean
Teaching Scholar. 1(2) 115–128.
Kösea,U (2010). A blended learning model supported with Web 2.0 technologies. Procedia Social and
Behavioral Sciences 2 (2010) 2794–2802.
Singh,H(2003). Building Effective Blended Learning Programs. Issue of Educational Technology,43-(6) 51-54.

23
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Attitudes of nursing and midwifery school's student toward blended learning at mazandaran university of medical sciences

  • 1. Journal of Education and Practice ISSN 2222-1735 (Paper) ISSN 2222-288X (Online) Vol.4, No.26, 2013 www.iiste.org Attitudes of Nursing and Midwifery School's student toward Blended learning at Mazandaran University of Medical Sciences Mohammadreza Neyestani Assistant Professor, Faculty of Educational Sciences and Psychology, University of Isfahan, Isfahan, Iran. E-mail: neyestani@gmail.com Hasan Babri (Corresponding author) MS student of, Educational planning, School of Educational Sciences and Psychology, University of Esfahan, ,Iran. E-mail: hasan.baabri@yahoo.com Abstract Blended Learning is an educational method which has been used recently in higher education worldwide. This study was conducted to investigate attitudes of the student of Nursing School at Mazandaran University of Medical Sciences toward blended learning. The present study is a descriptive- cross sectional research. The population included All students of Nursing and Midwifery Mazandaran University of Medical Sciences whom a randomly stratified sample of 134 were selected. Also, Buket & Soylu (2008b) blended learning Attitude Scale was used to measure attitude. Data were analyzed using descriptive indices.Results showed that, majority of the respondents had positive attitude toward blended learning and Very small number of them had negative attitudes. Also, there were no significant relationships between Varies (age and Gender) and the attitudes. So, According to the positive attitude of the respondents toward blended learning, it is recommended that further studies take place in order to design and implement the approach in formal education in the school of Nursing and Midwifery of mazandaran University of Medical Science. Key words: attitude, blended learning, student, School of Nursing and Midwifery Introduction Teachers concerned about the quality of learning in universities are facing a number of challenges related to information and communication technologies (ICT)( Ginns & Ellis ,2006). Information and communication technologies, which have been developing rapidly, have become one of the indispensable elements of the 21st century. They have influenced, like all other fields, educational institutions which are the most important subinstitutions of the social structure. They have offered a favorable environment for the development and use of various methods and tools (Buket & Soylu, 2006c). In today’s world, information and communication technologies are influenced in many different areas where people need more knowledge and better standards to accomplish their works. Education is one of these fields that information and communication technologies are substantially interested in. Especially, education needs innovations and new approaches to improve quality of educational studies (Hoic-Bozic, Vornar & Boticki, 2009). Thus, there is a considerable search for better education methods or techniques that are especially supported with advanced technologies. In time, a remarkable improvement has been succeeded in education, thanks to information and communication technologies. Many different methods, techniques and approaches have been developed and implemented to realize requirements in educational studies (Kösea, 2010). In recent years the spread of computer use, development of Internet technologies and fast Internet connection have paved the way for providing a significant part of distance education through the Internet. That is why, concepts such as e-learning, online learning or web-based learning, where Internet and network technologies are overwhelmingly used in the presentation and reception of the content, are used to refer to these learning environments rather than the concept of distance education which defines a quite larger area, including models of learning through letter and radio broadcasting (Buket & Soylu, 2006c). In spite of many advanced features of the online instructional mode, issues such as low levels of interaction, lack of varied instructional strategies, and poor instructional design are often cited as shortcomings when discussing the effectiveness of online instruction. Responding to these issues, many studies such as Oh, Lim and French, (2004) and Oh and Albright (2004) have discussed the advantages and disadvantages of the online instructional mode. Having acknowledged the disadvantages, advocates of online instruction have made efforts to overcome them in many ways. Some have claimed that online instruction restricts active student engagement in learning events unless the student is a self-motivated, active learner. Rovai (2003) claims that online instruction is often found to be “impersonal, superficial, misdirected, and potentially dehumanizing and depressing”, inhibiting the pedagogical values of instruction. In addition, other studies (Daniels and Moore, 2000; Ford and Chen, 2000) expressed that 18
  • 2. Journal of Education and Practice ISSN 2222-1735 (Paper) ISSN 2222-288X (Online) Vol.4, No.26, 2013 www.iiste.org online learning environments require students to be strongly motivated and self-directed, and possess strong organizational skills in their learning habits since working in online learning environments is an isolating and independent job. Considering the fact that sharing feelings, experiences, knowledge, and a sense of belonging (Valejs, 2003) is important in the learning process, online learning environments prevent both learners and instructors from experiencing those sharing opportunities in dynamic communication environments. Therefore, strategies have been suggested to improve online learning environments, and various instructional practices (e.g. blended instruction, hybrid instruction) have been attempted. Blended learning is treated as an instructional strategy, which is developed in a networked environment. Such a strategy is usually supported by virtual learning environments (VLEs), which are a computer-based standardized learning system and are used to sustain content delivery of online learning as well as to promote online communication between an instructor and learners (Huang, Ma1,& Zhang, 2008). Blended or hybrid learning is a wide-ranging term encompassing a range of different meanings. The definitions of blended learning vary depending on delivery media, instructional methods, and type of instruction (Graham, 2006). The most common and broadest definition is the emphasis on mixing types of instruction (i.e., traditional face-to-face instruction and online instruction; Graham, 2006; Rooney, 2003; Sands, 2002; Ward & LaBranche, 2003; Young, 2002). Graham (2006) summarizes three definitions of blended learning as the (a) combination of instructional delivery media, (b) combination of instructional methods, and (c) combination of online and face-to-face instruction. The first two definitions reflect the debate on instructional media versus instructional methods on learning and are too broad to make blended learning a distinct phenomenon since virtually all learning systems include a variety of methods and media. Blended learning is premised on two key aspects: the effectiveness of the mix mode or multiple media approach in terms of accessibility, and meeting students’ academic and non-academic needs. Blended learning combines the benefits of online learning and face-to-face instructions. It takes the best qualities or features from every delivery format, whether it is an online learning management system or a print- based correspondence study. It provides greater access to course material in one delivery mode than is perhaps available in another delivery mode. So, Blended learning combines various models of traditional and distance education and makes use of all types of technology, in other words it is a combination of conventional classroom instruction and e- learning. Factors such as learners’ individual differences, personal characteristics, their opinions and learning styles have significant impacts on a learning environment. For instance, the learners who have difficulty in establishing communication in the classroom environment may find it easier to communicate in the electronic environment. It is important, during the process of organizing blended learning environments, to establish the equilibrium between face-to-face education and online environments, in view of the advantages of both methods (Buket & Soylu, 2008). Blended learning combines multiple delivery media that are designed to complement each other and promote learning and application-learned behavior. Blended learning programs may include several forms of learning tools, such as real-time virtual/ collaboration software, self-paced Web-based courses, electronic performance support systems (EPSS) embedded within the job-task environment, and knowledge management systems. Blended learning mixes various event-based activities, including face-to-face classrooms, live elearning, and self-paced learning. This often is a mix of traditional instructor-led training, synchronous online conferencing or training, asynchronous self-paced study, and structured on-the-job training from an experienced worker or mentor (Singh, 2003). Blended learning is described by Thorne (2003) as “a way of meeting the challenges of tailoring learning and development to the needs of individuals by integrating the innovative and technological advances offered by online learning with the interaction and participation offered in the best of traditional learning” (Buket & Soylu, 2008a). Blended learning environment which is regarded as a different type of distance education amalgamates the advantages of distance education with the effective aspects of traditional education. In contrast to classical learning environment which poses restrictions on place and time, e-learning provides an environment where the learners can study regardless of time and place restrictions according to their learning speed. The factors such as 19
  • 3. Journal of Education and Practice ISSN 2222-1735 (Paper) ISSN 2222-288X (Online) Vol.4, No.26, 2013 www.iiste.org learners’ individual differences, personal characteristics and learning styles have significant impacts on the learning environment. For instance, the learners who have difficulty in establishing communication in the classroom environment find it easier to communicate in the electronic environment. As mentioned before, the disadvantages of e-learning deriving from the interruption of socialization process and the weakening attractiveness of e-learning applications in the eyes of learners are combined with relevant disadvantages of faceto-face education environments. It is obvious that the weaknesses and strengths of online environment and the weaknesses and strengths of face-to-face education integrate in blended learning (Buket & Soylu, 2006c). There are a number of potential advantages to blended learning that are emerging. Some of these revolve around accessibility, pedagogical effectiveness, and course interaction. Many of today’s college students are nontraditional, attempting to balance family, jobs, and university life. Coming to campus is often difficult for many of them and through reducing the number of face-to-face hours required, blended learning can help them meet this challenge. Universities and faculty are looking for ways to reach and retain these students (Dziuban, Moskal & Hartman, 2004). Blended learning has many advantages, which make it more popular among teachers and students. Some of these advantages can be listed as below: � By using combination of different education techniques and technologies, blended learning can improve students’ academic achievements. � Blended learning can be applied to students with different learning styles and levels. � Blended learning allows cost savings and lowers general education expenses. � Using various education techniques attracts more students’ attention to the course subject. � By using combination of face to face education and other education techniques, students can be allowed to access to knowledge from anywhere until they meet face to face with teachers(Kösea, 2010). In today’s competitive environment, schools need to be fully cognizant of the views and feelings of their primary stakeholders – the students. Given the fact that the students are at the centre of this process, it is imperative that their views on their experiences be obtained before contemplating any shift from the traditional face-to-face modality to blended learning (Kistow,2011). In the last decade, the blended learning approach has been adopted widely in schools, universities and training sections in the business world. One of the major reasons this approach is gaining momentum is due to teachers and instructors not using online learning to completely replace traditional face to face classroom teaching, but to complement or overcome some of the short comings of face to face teaching. In blended learning, instructors typically use computer technology with Internet access. The blended learning environment may be as simple as providing administrative information, reading materials, and resources for the students. However, some teachers and instructors enable students to interact with each other by using asynchronous and synchronous communication technologies (Cheung & Hew,2011). Nowadays, blended learning is one of the most advanced educational techniques. Considering the commencement of adopting such modern teaching techniques across the world as well as in the Iranian universities, one needs to apprehend the knowledge and attitude of students as one of the most important components in the education system. Thus, this study was designed to investigate the knowledge and attitude of students towards blended learning at Nursing Students at Mazandaran University of Medical Sciences. Method The present study is a descriptive- cross sectional research. The population included All students of Nursing and Midwifery mazandaran University of Medical Sciences whom a randomly stratified sample of 134 were selected. Also, Buket & Soylu (2008b) blended learning Attitude Scale was used to measure attitude. Data were analyzed using descriptive indices. Results The response rate of the participants was 94 percent (127 students) of whom 68 percent were female and 32percent male. The participants ranged in age from 19 – 28. Rate Attitudes of Nursing student toward Blended learning at mazandaran University of Medical Sciences, Be seen in Table 1. 20
  • 4. Journal of Education and Practice ISSN 2222-1735 (Paper) ISSN 2222-288X (Online) Vol.4, No.26, 2013 www.iiste.org Table 1. Attitudes of Nursing student toward Blended learning Items Totally agree I agree Number (percent) Number (percent) The Web environment helps me to follow courses easily 91(71/60) 34(26/77) Disagree Number (percent) 2(1/57) Whenever I need help in the web environment I can get it 88(69/29) 38(29/92) 1(0/78) I can reach the web environment wherever I want 76(59/84) 47(37) 4(3/14) The interaction in the web environment is quite enough for me The announcement section is prepared quite well The Web site is comprehensible I find the web site quite clear I can use the forum easily I can find the answers to questions provided in the Forum environment I can share my thoughts and experiences with my friends in the Forum environment Teaching staff give feedback through forum environment The forum is supportive and helps me reinforce what I have learned I find that communication and mentoring in the forum environment are quite enough Modules in the web environment are quite comprehensive including all achievements Achievements in all modules are always defined clearly Learning and teaching activities in all modules are always defined clearly Modules in the web environment meet my needs The explanation of the subject help me to learn the subject Worksheets help me to understand what I have learned References and narration met my needs Length and presentation of the subject help me to follow the subject easily The teacher completes missing subjects during the face to face sessions Generally, I can find the answers to my questions during the face to face sessions I can find the answers to my questions during the face to face sessions Face to face sessions help me to learn about subjects in detail Sharing and discussion environment in face to face sessions are quite good It would be better if teachers explained the subject during the face to face sessions Face to face interaction is quite useful for understanding the subject much better Face to face environment with gestures and mime is quite effective Face to face interaction helps me to learn better and assists in the retention of information about the subject 112(88/18) 12(9/44) 3(2/36) 64(50/39) 55(43/3) 41(32/28) 98(77/16) 54(42/51) 56(44/09) 66(51/96) 78(61/41) 27(21/25) 59(46/45) 7(5/51) 6(4/72) 8(6/29) 2(1/57) 14(11/02) 56(44/09) 62(48/81) 9(7/08) 73(57/48) 92(72/44) 46(36/22) 31(24/4) 8(6/29) 4(3/14) 70(55/11) 55(43/3) 2(1/57) 61(48/03) 55(43/3) 11(8/66) 42(33/07) 38(29/92) 71(55/9) 76(59/84) 14(11/02) 13(10/23) 93(73/22) 51(40/15) 87(68/5) 88(69/29) 58(45/66) 29(22/83) 68(53/54) 37(29/13) 35(27/55) 68(53/54) 5(3/93) 8(6/29) 3(2/36) 4(3/14) 1(0/78) 118(92/91) 9(7/08) 0 72(56/69) 50(39/37) 5(3/93) 68(53/54) 48(37/79) 11(8/66) 70(55/11) 54(42/51) 3(2/36) 67(52/75) 51(40/15) 9(7/08) 71(55/9) 54(42/51) 2(1/57) 49(38/58) 66(51/96) 12(9/44) 95(74/8) 28(22/04) 4(3/14) 52(40/94) 67(52/75) 8(6/29) 21
  • 5. Journal of Education and Practice ISSN 2222-1735 (Paper) ISSN 2222-288X (Online) Vol.4, No.26, 2013 www.iiste.org If something went wrong in web environment, we would need face to face interaction to make things clear Evaluation criteria in the web environment guide us in how and what to do in our projects Mentoring about the projects help us a lot and makes the Project easy for us Evaluation criteria is clear and understandable Interval assessments during face to face sessions help us to complete the projects easily To learn through website makes me responsible for the course and motivates me to attend the course To learn the subject through the web site is much more interesting than other methods My motivation is very low while I am studying on the web It is very new and different way to study on the web It is very difficult to study on the web for me To come the class with the preparation helps my learning a lot I believe that this is a very effective system I can study by myself in a more comfortably and in a quiet environment This method is easier for me To study on the web help me make plans I can study at my own pace I get bored when I am studying on the web I find the forum environment very boring The Web environment helps us prepare for the course I can study over and over again in the web environment Total(percent) 97(76/37) 27(21/25) 3(2/36) 49(38/85) 70(55/11) 8(6/29) 119(93/7) 8(6/29) 0 71(55/9) 107(84/25) 39(30/7) 20(15/74) 17(13/38) 0 41(32/28) 67(52/75) 19(14/96) 85(66/92) 33(25/98) 9(7/08) 67(52/75) 104(81/89) 80(62/99) 117(92/12) 49(38/58) 23(18/11) 41(32/28) 10(7/87) 11(8/66) 0 6(4/72) 0 51(40/15) 83(65/35) 62(48/81) 41(32/28) 14(11/02) 3(2/36) 114(89/76) 54(42/51) 98(77/16) 48(37/79) 60(47/24) 101(79/52) 60(47/24) 12(9/44) 65(51/18) 29(22/83) 77(60/62) 57(44/88) 26(20/47) 63(49/6) 1(0/78) 8(6/29) 0 2(1/57) 10(7/78) 0 4(3/14) 59/14 36/29 4/57 According to Table 1- The majority of the respondents had (59/14) percent had completely positive attitude, (36/29) percent had positive attitude toward blended learning; and Small number of respondents (4/57) percent of them had negative attitudes. Also, statistical analysis showed that there were no significant relationships between Varies (age and Gender) and the attitudes. Conclusion blended learning is one of the most advanced educational techniques. Considering the commencement of adopting such modern teaching techniques across the world as well as in the Iranian universities, one needs to apprehend the knowledge and attitude of students as one of the most important components in the education system. Thus, this study was designed to investigate the knowledge and attitude of students towards blended learning at Nursing Students at Mazandaran University of Medical Sciences. Results showed that (59/14) percent Respondents Said Completely agree with blended learning and (36/29) percent Respondents Said Agree with blended learning , that According to these findings Can be concluded that majority of the respondents had positive attitude toward blended learning. Also, statistical analysis showed that There was no significant relationships between Varies age and the attitudes. Because the blended e-learning uses benefits of both e-learning & face to face learning and provides more flexibility and satisfaction for learner and teacher, it can be considered as an effective alternative method for education in universities of medical sciences in Iran. So, According to the positive attitude of the respondents toward blended learning, it is recommended that further studies take place in order to design and implement the approach in formal education in the school of Nursing and Midwifery of mazandaran University of Medical Science. 22
  • 6. Journal of Education and Practice ISSN 2222-1735 (Paper) ISSN 2222-288X (Online) Vol.4, No.26, 2013 www.iiste.org References Buket, A, & Soylu, M. Y. (2008a). A Study of Student’s Perceptions in a Blended Learning Environment Based on Different Learning Styles. Educational Technology & Society, 11 (1), 183-193. Buket, A, Soylu, M, Y (2008b). Development of a scale on learners' views on blended learning and its implementation process. Internet and Higher Education 11. 26–32. Buket, A. Soylu M Y. (2006c) A Study on Students’ Views On Blended Learning Environment. Turkish Online Journal of Distance Education.3(3) 7. Cheung, W,S. and Hew, K,F(2011). Design and evaluation of two blended learning approaches: Lessons learned. Australasian Journal of Educational Technology 27(Special issue, 8), 1319-1337. Dziuban,CH. Moskal,P. and Hartman,J(2004). HIGHER EDUCATION, BLENDED LEARNING AND THE GENERATIONS: KNOWLEDGE IS POWERNO .MORE Research Initiative for Teaching Effectiveness, LIB 118University of Central Florida. Ginns, P. Ellis, R.(2007). Quality in blended learning: Exploring the relationships between on-line and face-toface teaching and learning The Institute for Teaching and Learning. Internet and Higher Education (10) 53– 64. Huang,R. Ma1,D. and Zhang,H (2008). Towards a Design Theory of Blended Learning Curriculum. ICHL '08 Proceedings of the 1st international conference on Hybrid Learning and Education.(3), 66 – 78. Kistow, B(2011).Blended learning in higher education: A study of a graduate school of business, Trinidad and Tobago Arthur Lok Jack Graduate School of Business, The University of the West Indies, St. Caribbean Teaching Scholar. 1(2) 115–128. Kösea,U (2010). A blended learning model supported with Web 2.0 technologies. Procedia Social and Behavioral Sciences 2 (2010) 2794–2802. Singh,H(2003). Building Effective Blended Learning Programs. Issue of Educational Technology,43-(6) 51-54. 23
  • 7. This academic article was published by The International Institute for Science, Technology and Education (IISTE). The IISTE is a pioneer in the Open Access Publishing service based in the U.S. and Europe. The aim of the institute is Accelerating Global Knowledge Sharing. More information about the publisher can be found in the IISTE’s homepage: http://www.iiste.org CALL FOR JOURNAL PAPERS The IISTE is currently hosting more than 30 peer-reviewed academic journals and collaborating with academic institutions around the world. There’s no deadline for submission. Prospective authors of IISTE journals can find the submission instruction on the following page: http://www.iiste.org/journals/ The IISTE editorial team promises to the review and publish all the qualified submissions in a fast manner. All the journals articles are available online to the readers all over the world without financial, legal, or technical barriers other than those inseparable from gaining access to the internet itself. Printed version of the journals is also available upon request of readers and authors. MORE RESOURCES Book publication information: http://www.iiste.org/book/ Recent conferences: http://www.iiste.org/conference/ IISTE Knowledge Sharing Partners EBSCO, Index Copernicus, Ulrich's Periodicals Directory, JournalTOCS, PKP Open Archives Harvester, Bielefeld Academic Search Engine, Elektronische Zeitschriftenbibliothek EZB, Open J-Gate, OCLC WorldCat, Universe Digtial Library , NewJour, Google Scholar