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Contents lists available at ScienceDirect

Teaching and Learning in Nursing

journal homepage: www.journals.elsevier.com/
teaching-and-learning-in-nursing

Research

Persian version of nursing students’ perceptions of an Online course

scale: Translation and psychometric testing
Zahra Tayebi Myaneh1, Long She2, Hamid Sharif Nia3,4, Kelly-Ann Allen5,6,
Pardis Rahmatpour1*
1
Department of Nursing, Alborz University of Medical Sciences, Karaj, Iran
2
Sunway Business School, Sunway University, Sunway City, Malaysia
3
Educational Development Center, Mazandaran University of Medical Sciences, Sari, Iran
4
Department of Nursing, Amol Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
5
School of Educational Psychology and Counselling, Faculty of Education, Monash University, Clayton, Australia
6
Centre for Wellbeing Science, Melbourne Graduate School of Research, University of Melbourne, Parkville, VIC, Australia

A R T I C L E I N F O A B S T R A C T

Article History: The purpose of the present study is to evaluate the psychometric properties of the Persian version of the stu-
Accepted 1 April 2023 dent perceptions of an online course (P-SPOC) measure among Iranian nursing students. In this cross-sec-
tional study a total of 302 Iranian undergraduate nursing students filled the online questionnaire between
Keywords: October and December 2021. Validity (construct, convergent and divergent), and reliability of the P-SPOC
Nursing students were evaluated. For ensuring high quality the presence observational study the STROBE checklist was ful-
Online course
filled. Total variance explained of the P-SPOC for the two factors namely course components and course for-
Reliability
mat was estimated 51.84%. Using confirmatory factor modeling two factors have acceptable composite
Validity
reliability, convergent and divergent validity. These results confirmed that the Persian version of the SPOC is
a reliable and valid measure to assess nursing student perceptions of online courses in Iran.
© 2023 Organization for Associate Degree Nursing. Published by Elsevier Inc. All rights reserved.

Introduction some students reporting less connection to instructors, students

resulting in lowered engagement (Cole et al., 2021; Dumford & Miller,
Rapid advances in technology have created new ways of sharing 2018; Yuhanna et al., 2020). Various reasons that cause students to
and communicating knowledge (Keane et al., 2022). The use of digital feel isolated in online learning contexts have been identified and
tools for teaching and learning has increased quickly alongside the include several factors such as insufficient support, instructor behav-
rise in online education offerings (Hermawan, 2021) following the ior, course structure, and learning materials (Barclay et al., 2018).
Coronavirus disease 2019 (COVID-19) pandemic when for many stu- Such challenges can be common in online courses and can result in
dents, online learning became a necessity. Online learning is becom- lowered engagement, satisfaction (Sharif Nia et al., 2022; She et al.,
ing a recognized medium and solution for delivering educational 2021), academic performance, and their rate of success (Rahmatpour
content throughout the higher education sector (Efriana, 2021). et al., 2019; Rahmatpour et al., 2021).
Online learning enables students to access online courses and infor-
mation without time and geographical barriers (Iravani et al., 2022).
Other benefits include the reduction of educational costs, increased Background
potential for scientific advancement due to the rapidity of knowledge
transfer, improved technical skills and learning processes, and access Students’ experiences in online learning has become a critical con-
to dynamic course content that may be more readily updated (Sharif cern for many higher education institutions, including Iranian univer-
Nia et al., 2022; Taghizadeh et al., 2022). sities. Online education was not a common occurrence in Iran before
Notwithstanding the benefits, online learning, like traditional lockdown measures during COVID-19. With diminished Faculty sup-
face-to-face contexts, also carry drawbacks. A common concern about port due to staff cuts, designing and implementing quality online
online learning is its potential to be isolating for some students with learning opportunities has been challenging for some universities,
students, and instructors. For instance, one study found the lack of
infrastructure and technology was a central barrier in online learning
*Corresponding author: (Taghizadeh et al., 2022). Such barriers have been argued to be more
E-mail address: [email protected] (P. Rahmatpour). pronounced for students in medical and health related disciplines

https://doi.org/10.1016/j.teln.2023.04.001
1557-3087/© 2023 Organization for Associate Degree Nursing. Published by Elsevier Inc. All rights reserved.

Please cite this article as: Z. Tayebi ?Myaneh et al., Persian version of nursing students’ perceptions of an Online course scale: Translation and
psychometric testing, Teaching and Learning in Nursing (2023), https://doi.org/10.1016/j.teln.2023.04.001
JID: TELN
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2 Z. Tayebi ?Myaneh et al. / Teaching and Learning in Nursing 00 (2023) 1 5

(e.g., nursing), where experiential learning is required alongside high via social networking apps such as Channel and a group in WhatsApp
standards of technology and infrastructure support (Khodaei et al., and Telegram. Students who were undergraduate of nursing, willing
2022). To minimize adverse effects from the lack of infrastructure to participate in the study and had experience in online classes were
and technology required for satisfactory online learning, it is impor- invited to the study. According to Kellar and Kelvin (2012), the sam-
tant for universities to prioritize quality course design, which has ple size for a factor analysis between 5 and 10 per item is acceptable.
been shown to a critical factor in students’ online learning experien- Therefore, for the exploratory factor analysis (EFA) that the original
ces (Laksana, 2021). Thus, understanding students' experiences about 31-item scale evaluated, 186 sample (31 £ 6 = 186); and to evaluate
online learning becomes imperative. However, to date, limited tools the extracted items (n = 19) by confirmatory factor analysis (CFA) 114
have been developed to access students’ experiences and perceptions students were collected (19 £ 6 = 114). In total, 302 students from
about online courses with less available that have been psychometri- three universities completed the form.
cally validated with Iranian populations.
There are few surveys measuring student’s experiences and Instruments
perceptions of online have been developed and readily available.
Some examples include the course experience questionnaire The survey questionnaire contained two parts: (1) demographic
(CEQ), the questionnaire satisfaction of university students and educational information of students and (2) the Persian version
towards online training, and a few researcher-designed question- of the SPOC (P-SPOC). The original SPOC had 31 items in 3 subscales,
naires (Ruiz-Grao et al., 2022). The existing tools need updating, namely student engagement, organization, and resources (Chung &
have a too many items, or do not correspond to the realities of Chen, 2020). Student engagement is described as active participation,
today's online learning. Gosak et al.(2021) recently developed and interaction, and collaboration in the online settings. Organization
evaluated the DREEM tool to measure nursing students’ percep- measures perception of effective course design and clear course
tion of the online learning environment. It consists of 50 items in objectives and learning outcomes. Resources refers to any materials,
five subscales, while the measure is valid, a shorter version has staff, and other assets available that can support students'
not been developed and evaluated. learning. The coefficient alpha for the factors was 0.97, 0.96, and 0.89
There is a need to assess students' perceptions on how to improve respectively.
the quality of e-learning that is reliable, up-to-date, and user friendly Item scaling was created as a 5-point Likert scale. Responses rang-
(i.e., short). The current study aims to evaluate the psychometrics of ing from 1 to 5 (strongly disagree to strongly agree respectively).
the Persian version of the student perceptions of an online course Thus the summed range of scores range from 31 to 155.
(SPOC) survey in Iranian nursing students. The SPOC consists 31
items with three factors, including student engagement, organiza- Data Analysis
tion, and resources (Chung & Chen, 2020). It is a valid and reliable
tool for assessing online courses in RN-to-BSN programs among nurs- Exploratory and confirmatory factor analysis was used to evaluate
ing students. It is considered one of the most comprehensive tools construct validity of P-SPOC by SPSS-AMOS27. Factor extraction in
available (Chung & Chen, 2020). EFA was done using maximum likelihood with Promax rotation. Also
Considering the importance of online learning and the compre- to determine how suited data is for EFA, Kaiser Meyer Olkin (KMO)
hensiveness of the SPOC tool, this research aims to first translate the and Bartlett’s test were used.
SPOCE into Persian and then evaluate psychometric properties of the Horn's parallel analysis was run to estimate the number of factors
Persian version pf SPOC among undergraduate nursing students in to keep in EFA (Dinno, 2009). Next a maximum likelihood estimation
Iran. To the best of the researchers’ knowledge, this is the first study in confirmatory factor analysis (CFA) was conducted and goodness
to translate this tool into another language and evaluate the psycho- of fit indices (x2 test, x2/df< 3, RMSEA<.08, CFI, IFI, and TLI> 0.9
metric properties of the translated version. (Sun, 2005).
We applied best practices for assessing reliability, convergence,
Methods and discriminant validity based on multiple criteria and an explana-
tion of sampling error (Cheung et al., 2023). The divergent and con-
Design vergent and validity of the P-SPOC assessed by Composite Reliability
(CR) and Average Variance Extracted (AVE). In order to establish con-
The current study used a cross-sectional design to evaluate the vergent validity, there must be a criterion of CR > .7, AVE> .5, and
psychometric properties of the Persian version of the SPOC instru- AVE< CR (She et al., 2021). To assess divergent validity assessment
ment among Iranian nursing students between October and Decem- was used Fornell & Larcker criterion (Ab Hamid et al., 2017), The AVE
ber 2021. In this study, the translation process started after obtaining must be greater than its correlation values with other constructs
written permission to use the SPOC from the scale developer. Accord- (Fornell & Larcker, 1981).
ing to the World Health Organization (2016) protocol, the for- Finally, for assessing reliability of the P-SPOC the internal consis-
ward backward translation technique was used. The SPOC was tency was asserted by Cronbach’s alpha, McDonald’s omega, CR, and
translated into Persian by two independent translators and any dif- maximum reliability (MaxR). The acceptable value for these indica-
ferences were resolved through comprehensive discussion. The scale tors is greater than .7 (Rahmatpour et al., 2021).
was then back-translated independently into English by another This study assessed both univariate and multivariate (Mardia's
team (i.e., bilingual experts fluent in English and Persian) who were coefficients of multivariate skewness and kurtosis) normality. The
unaware of the original English version. The final version of the scale multivariate outliers were identified using Mahalanobis d-squared
was sent to the developer for consideration. distance (p< 0.001) (Kline, 2015).

Population and Sample Ethical Considerations

To be included in this study, participants were current students in The protocol of this study was approved by Ethic committee of
a bachelor-level nursing degree who had experienced online learning Alborz university of medicals sciences [Ethic code: IR.ABZUMS.
in university. The online questionnaire was created using Google REC.1400.111]. The study aim, information about items, voluntary
Forms, and the URL link for the questionnaire was sent to students participation, the possibility of withdrawing from the study at any

Please cite this article as: Z. Tayebi ?Myaneh et al., Persian version of nursing students’ perceptions of an Online course scale: Translation and
psychometric testing, Teaching and Learning in Nursing (2023), https://doi.org/10.1016/j.teln.2023.04.001
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Table 1 Results
Characteristics of Students (n=302)
In the current study, most student participants were single
Variables n(%)
women. Other demographic and educational information are pro-
Gender vided in Table 1.
Female 189(62.6)
Male 113(37.4)
The KMO (0.951) and Bartlett test (3858.387, p <0.001) showed
Marital status that strength of the partial correlation between the variables are
Single 259(85.8) suited to EFA. Based on the EFA results, a two-factor subscale was
Married 43(14.2) determined, that is course components and course format (Fig. 1 and
Academic year
Table 2). These two factors explained 51.84% of the total variance of
First year 87(28.8)
2nd year 108(35.8) the P-SPOC among the nursing students.
3rd year 93(30.8) The fit indices of the CFA model showed that x2= 333.071, DF=
4th year and above 14(4.6) 145, x2 /df= 2.297, CFI= .950, IFI= .951, and TLI= .941, and RMSEA=
Age(mean §SD) years 20.05§6.0 .066.
GPA(mean §SD) of 20 16.60§1.3
Based on the reported indices in Table 3 showed that the
P-SPOC has good convergent and divergent validity. Also, the factors
extracted from this scale had good internal consistency and reliability.

time, and confidentiality and anonymity of information were inserted Discussion

on the first page of the online questionnaire. In this study, informed
consent was obtained online. After reading the above information, The present study evaluated nursing students’ perceptions about
the participant could see the questionnaire questions by clicking on online courses to assess the psychometric properties of the translated
the "NEXT" option. P-SPOC scale. Based on the results, the two factors extracted were

Fig. 1. The two-structure model of the Persian version of SPOC.

Please cite this article as: Z. Tayebi ?Myaneh et al., Persian version of nursing students’ perceptions of an Online course scale: Translation and
psychometric testing, Teaching and Learning in Nursing (2023), https://doi.org/10.1016/j.teln.2023.04.001
JID: TELN
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Table 2
The Results of EFA of 19 Items of Persian Version of SPOC (N = 186)

Factors Items Factor h2* λ** Variance (%)

Loading

Course 26) The course facilitates student achievement of the stated course objectives. 0.901 0.743 6.35 33.42
components 27) The course learning content provides students to achieve the four domains of learning outcomes 0.891 0.758
(Patient-centred Care, Inquiry and Reasoning, Roles and Collaboration, and Quality and Safety).
29) The course provides the quality of learning activities/assignments for each week. 0.773 0.605
21) The course fosters student-to-student interaction for supporting learning. 0.773 0.555
23) The course provides information as to where to get technical support. 0.747 0.546
24) The course provides additional course content and related materials (e.g., handouts and forms, 0.719 0.577
videos, other websites, etc.) for supporting students’ learning effectively.
22) The course provides various methods for communication (e.g., online, phone, and email). 0.703 0.511
20) The instructor encourages student participation and questions. 0.694 0.532
13) Learning activities in the course encourage students to explore diversity of interests. 0.667 0.533
25) The course provides information as to where to get library support. 0.648 0.382
28) Learning activities/assignments are realistic and appropriate for course workload. 0.601 0.528
18) The instructor is supportive when a student had difficulties or questions. 0.500 0.465
Course format 4) Each week’s materials have consistent design elements (e.g., font sizes, color, paragraphing, and spacing). 0.880 0.602 3.50 18.42
6) The course follows a format (structure/layout) that is recognizable and comfortable. (e.g., even though 0.801 0.637
content is different, future modules are easy to navigate because of experience with
beginning modules).
5) All links (internal and external) are valid and active. 0.726 0.460
3) The course navigation is easy to follow. 0.705 0.551
10) Learning content is logically sequenced 0.676 0.631
9) The course content appears to be current for the subject matter presented. 0.542 0.613
11) Instructions for assignments/learning activities are clear. 0.522 0.567
* h2, item communality,
** λ, eigenvalue,
Total variance: 51.84%

course components and course format explaining 51.84% of the total of teaching and learning processes, course structure, and student
variance of the P-SPOC among the nursing students sampled. support. The results showed that the course structure (i.e., course
To the best of our knowledge, this is the first study to assess the objectives, resources, assignments) was rated the highest (M = 3.508,
structure of the SPOC scale in another context, and, for this reason, SD = .656) among the three dimensions.
only comparisons with the main tool are made herein. Three differ- The second factor extracted in the present study, “course format”
ences were found between the structure of the original scale and the with 7 items, referred to design format such as font size, paragraph-
Persian version. First, the original scale was composed of 31 items, ing, sequence of content, course links and navigations.
but the Persian version was reduced to 19 items. Second, based on According to the CFA results and the values of model fit indices,
the EFA results of the original scale with Varimax rotation, many the P-SPOC demonstrated a good model of fit. The reliability results
cross loadings between factors were found. In other words, many of the P-SPOC demonstrated strong internal consistency. In this
items loaded highly onto multiple factors. Therefore, we used the study, in addition to Cronbach's alpha coefficient, the McDonald's
Promax rotation instead of the Varimax rotation and deleted items omega and CR were used to check the reliability of the P-SPOC.
with cross-loadings of more than 0.4 in multiple factors. Last, the McDonald’s omega has been used as a popular alternative to Cron-
goal of factor extraction is to maximize the explained variance and bach alpha in the literature (Zhang & Yuan, 2016). CR has never been
the total variance of the original scale was 75.25% while the two fac- under suspicion of sampling bias (Ten Berge & So
can, 2004). How-
tors in the present study only accounted for 51.85% of the variance. ever, the original scale’s reliability was assessed only by Cronbach's
This is due to the different rotation methods and extraction methods alpha coefficient (Chung & Chen, 2020).
used in the EFA for the present and past study. The items of the origi-
nal scale were extracted by principal component analysis (PCA) but Limitations of the Work
the maximum likelihood method was used in the present study. The
PCA explains the greatest share of variance, and even for the same Convenience sampling method and difference in the type of stu-
number of common factors or principal components, the average dents participate in this study are the limitations (The original scale
squared residual, across the entire covariance matrix, will be smaller was developed for RN-to-BSN students). Students’ perceptions may
for a EFA model than for a PCA. be different near the beginning or end of the course, so this study
The EFA used in the present study extracted two factors. The first was conducted in the middle of the autumn semester (Septem-
factor, “course components” consisted of 12 items that assessed stu- ber January in Iran). Also, social desirability bias, which can result
dents’ perceptions about course requirements, such as providing from the use of Likert scales in surveys, could cause respondents to
objectives, assignments, and interactions. Stewart and Lowenthal choose answers that do not accurately reflect their actual experiences
(2021) assessed Korean exchange students’ perceptions of the quality or opinions. Finally, although the P-SPOC scale was found to have
good psychometric properties in this study, its validity and reliability
Table 3 may differ in diverse populations and settings, highlighting the need
Results of the Construct Reliability and Convergent Validity (N = 302) for further research to confirm its robustness.

Factors Cronbach’s McDonald’s CR Max R AVE

Conclusion
Alpha Omega

Course components .744 .748 .753 .763 .435 The results demonstrated that the P-SPOC has good construct,
Course format .770 .775 .776 .783 .412
convergent, and divergent validity and reliability, and good model of

Please cite this article as: Z. Tayebi ?Myaneh et al., Persian version of nursing students’ perceptions of an Online course scale: Translation and
psychometric testing, Teaching and Learning in Nursing (2023), https://doi.org/10.1016/j.teln.2023.04.001
JID: TELN
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evaluation of postgraduate nursing student academic satisfaction scale. Nursing
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No conflict of interest has been declared by the authors. Ruiz-Grao, M. C., Cebada-Sanchez, S., Ortega-Martínez, C., Alfaro-Espín, A.,
Candel-Parra, E., García-Alcaraz, F., et al. (2022). Nursing Student Satisfaction with
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Sharif Nia, H., Azad Moghddam, H., Maro ^ co, J., Rahmatpour, P., Allen, K.-A., Kaur, H., . . .
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