Self-Perceived Readiness of Sudanese undergraduate dental students toward E- learning during the ongoing war conflict. A questionnaire-based study

Self-Perceived Readiness of Sudanese undergraduate dental students toward E- learning during the ongoing war conflict. 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A questionnaire-based study Elhadi Mohieldin Awooda, Yageen Diaeldin Elkheir, Samah Mahjoub Albadri, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9303721/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 8 You are reading this latest preprint version Abstract Background E-Learning is defined as a learning method that uses digital technologies and the internet to deliver educational content anytime and anywhere. This study aimed to assess the self-perceived readiness of Sudanese undergraduate dental students toward E-learning during the ongoing war conflict. Methods A descriptive cross-sectional study was conducted among 355 (third, fourth, and fifth years’) undergraduate dental students residing inside and outside Sudan. They were selected from fifteen private and governmental dental schools, in the period between August and September 2025 during the ongoing war conflict in Sudan. A Google Form questionnaire was distributed online through students' Watts Up groups. It included demographic data and the Online Learning Readiness Scale (OLRS) with some modifications. Data were analyzed by t-test and ANOVA for parametric data, and chi-square test for nonparametric data, with the level of statistical significance set at P = < 0.05. Results The response rate was 343 (96.6%), E-learning readiness was above the midpoint (M = 3.34 ± 0.62). Online Communication Skills was the highest domain (M = 3.90 ± 0.88), while Motivation for Learning was the lowest domain (M = 2.79 ± 0.73). Private university students showed higher readiness (M = 3.44 ± 0.62) than government one (M = 3.21 ± 0.59). Similarly, students residing outside Sudan had significantly higher readiness (M = 3.42 ± 0.59) compared to those inside Sudan (M = 3.27 ± 0.63). The major challenges reported included lack of motivation (51.8%), inability to focus due to stress (47.3%), and electricity challenges (41.1%). Students expressed the need for technical (42.2%), academic (35.5%), interactive sessions (25.9%), and psychological support (15%) to enhance their e-learning experience. Conclusion Sudanese undergraduate dental students demonstrated an acceptable level of E-learning readiness despite the challenges. Persistent challenges related to digital infrastructure continue to hinder the effectiveness of E-learning. However, further improvements are required to enhance education. Online learning Virtual learning Interactive lecture Self-directed learning Figures Figure 1 Introduction E-learning is defined as "an instructional process that gives online learners access to a wide range of resources—teachers, other learners, and content such as readings and exercises—independently of place and time." [ 1 ] The ongoing conflict in Sudan, which started on April 15, 2023, has impacted higher educational institutions in Khartoum State and beyond, with approximately 79.3% of universities experiencing military attacks. [ 2 ] Higher educational institutions have implemented E-learning as a critical instrument for continuous learning during the ongoing war conflict. Specifically, 44.8% of universities are shifting toward E-learning, ensuring that learning remains uninterrupted and adaptable, despite external disturbances. [ 2 ] A recent study in 2024 evaluating dental students’ readiness for E-learning across six countries showed that Sudanese students scored significantly lower in all five domains of the Online Learning Readiness Scale (OLRS); (self-directed learning, motivation for learning, computer/internet self-efficacy, learner's control, and online communication self-efficacy), and this lower score was attributed to lower financial support for higher education in Sudan. [ 3 ] However, during this war conflict numerous challenges hinder an effective shift to E-learning, including unreliable electricity, poor Internet connectivity, and inadequate digital infrastructure, [ 4 ] similar to others with the same situation. [ 5 , 6 ] In Sudan, many studies were conducted during the COVID-19 pandemic. Still, there remains a notable gap in studies assessing the readiness of university students in the Sudanese context, where the ongoing war has displaced students both internally and externally, leading to variations in their learning environments. Therefore, the main objective of this study was to assess the self-perceived readiness for E-learning among Sudanese undergraduate dental students, while the specific objectives were to identify key barriers facing students learning readiness during war conflict. Also, to compare findings of the Online Learning Readiness Scale (OLRS) between students from private and government universities, and between those who reside outside and those inside Sudan. Materials and Methods Ethical Approval: The study was approved by the Ethical Committee from the Faculty of Dentistry, El-Shiekh Abdallah Elbadry University-Berber, Sudan. (No.: EAEU-D‑REC002; 08.2025). All procedures performed in the study were conducted in accordance with the ethical standards given in 1975 Declaration of Helsinki, as revised in 2013. Participation was voluntary, informed signed online consent was obtained, and the anonymity of participants was ensured. Study design, Area and Duration: A descriptive cross-sectional study was conducted among undergraduate dental students of fifteen (governmental and private) universities, where thirteen were from Khartoum state and two from El-Gezira state, which were affected at the beginning of the ongoing conflict. The study duration was between August 2025 and September 2025. Study population: The study targeted third-, fourth-, and fifth-year dental students because of their higher academic maturity, greater exposure to both traditional and E-learning methods, and consistent attendance during the conflict period. First and second students, graduates and those who did not attend E-learning where excluded. Sample size and technique: The total number of students from the third-, fourth-, and fifth-year was 4,186. Accordingly, the required sample size, calculated using Cochran's formula, [7] was 352. The sample was proportionally distributed according to the stratification of the universities, applying a stratified random sampling technique to ensure representative participation from all the universities. After determining the number of participants required from each university, students were invited to complete the questionnaire using Google Forms, which were distributed online through their WhatsApp accounts. Participants were also encouraged to share the questionnaire with colleagues to reach the intended sample size. Non probability sampling was adopted because of limited access to students, many of whom had been displaced by the ongoing conflict, making direct contact with all participants challenging. This combination of stratified and convenience sampling ensured both representativeness and an efficient data collection. Data collection tool and procedure: A structured questionnaire based on the validated Online Learning Readiness Scale .(OLRS) [8] The instrument assesses five domains: Self-Directed Learning (SDL), Motivation for Learning (MFL), Computer/Internet Self-Efficacy (CIS), Learner’s Control (LC), and Online Communication Self-Efficacy (OCS). The questionnaire was adapted from a previous study, [3] with some modifications to suit the ongoing conflict situation. The final questionnaire consisted of three sections: Section A: demographic data (sex, type of institution, academic year, and current residence). Section B: The Online Learning Readiness Scale (OLRS) consisted of sixteen items (five questions measured computer/internet self-efficacy (CIS; Cronbach’s α = 0.65), three questions measured self-directed learning (SDL; Cronbach’s α = 0.63), three questions measured learner's control (LC; Cronbach’s α = 0.68), three questions measured motivation for learning (MFL: Cronbach’s α = 0.75), and two questions measured online communication self-efficacy (OCS: Cronbach’s α = 0.63). Section C: Barriers to online learning during the conflict. Data analysis: The collected data were analyzed using IBM SPSS Statistics version 29.0 (IBM Corp., Illoins, USA). Descriptive statistics, including frequencies, percentages, means, and standard deviations, were calculated to summarize participants’ demographic characteristics and domain scores. A one-sample t-test compared the mean total readiness score with the theoretical neutral point, and chi-square tests examined differences in reported challenges across demographic groups. To compare readiness levels across the five domains, a repeated-Measures ANOVA was performed. Mauchly’s Test indicated a violation of sphericity (p < 0.001), so the Greenhouse-Geisser correction was applied. Despite significant deviations from normality in the Kolmogorov–Smirnov and Shapiro–Wilk tests (p < 0.05), the large sample size (n = 355) supported the use of parametric analysis based on the Central Limit Theorem. Significant effects were further examined using Bonferroni-adjusted post-hoc pairwise comparisons. The significance level was set at p < 0.05. Results The response rate was (96.6%), with 343 of 355 dental students included in the e-learning readiness (OLRS scale) analysis. These students where included after 12 participants were excluded due to missing data in the scale items. The demographic analysis indicated that the majority of participants were female students 290 (81.7%), while the remaining demographic data were detailed in Table 1. Table 1 Sample Characteristics of Sudanese Dental Students (N=355) Characteristic Category Frequency (%) Sex Female 290 (81.7%) Male 65 (18.3%) Institution Type Government 156 (43.9%) Private 199 (56.1%) Current Residence Inside Sudan 191 (53.8%) Outside Sudan 164 (46.2%) Study Year 3 rd Year 88 (24.8%) 4 th Year 158 (44.5%) 5 th Year 109 (30.7%) The overall e-Learning readiness among Sudanese dental students was significantly (t (342) = 10.19) above the midpoint of 3.0 (M = 3.34 ±0.62, 95% CI [3.27, 3.41]). The analysis revealed a statistically significant difference among the mean scores of the five e-learning readiness domains (F (3.51, 1199.91) = 161.89, p < 0.001, partial = 0.321). The Online Communications Skills (OCS) domain had the highest mean score (M = 3.895), significantly (p < 0.001) higher than all other domains. Motivation for Learning (MFL) had the lowest mean score (M = 2.787). Self-Directed Learning (SDL) and Learner Control (LC) were the only two domains that didn’t show a statistically significant difference as detailed in Table 2. Table 2 Comparative Analysis of E-learning Readiness across the Five Online Learning Readiness Domains Online Learning Readiness Domains Mean Std. Deviation 95% Confidence interval Significant Differences OCS 3.90 0.88 [3.801, 3.989] a CIS 3.62 0.76 [3.534, 3.696] b SDL 3.20 0.87 [3.109, 3.293] c LC 3.20 0.90 [3.106, 3.296] c MFL 2.79 0.73 [2.710, 2.865] d Means in the same column do not share a common superscript letter (a, b, c, d) are statistically significantly different from each other at p<.05 level. OCS= Online Communication Skills, CIS= Computer/ Internet self-efficacy, SDL= Self-directed Learning, LC= Learning control, MFL= Motivation for Learning. As shown in Table 3, e-learning readiness was significantly higher among students from private universities and those outside Sudan, with no significant difference for previous e-learning experience or academic year. The relationship between students’ readiness scores and their access to a quiet and safe environment for e-learning indicated no significant correlation between the two variables, ρ (341) = 0.12, p = 0.829. Table 3 Comparison of E-learning Readiness Across students Characteristics Characteristic Comparison Mean (M) p-value University Type Private 3.44±0.62 <0.001 Government 3.21±0.59 Current residence Outside Sudan 3.42±0.59 0.019 Inside Sudan 3.27±0.63 E-learning Experience Yes 3.34±0.63 0.906 No 3.33±0.59 Academic Year 3 rd 3.27±0.73 0.463 4 th 3.34±0.56 5 th 3.39±0.60 A p-value ˂ 0.05 indicates Statistical significance. The most prevalent challenge associated with e-learning was lack of motivation 184 (51.8%). This was followed by an inability to focus due to stress as reported by 168 (47.3%). Additionally, a considerable number of students, 165 (46.5%), identified poor internet connectivity and limited interactions with instructors, 156(43.9%), as key barriers. Lastly, 146 (41.1%) of students had electricity challenges. Variations in the prevalence of the reported challenges across institution type and the current residence of students the findings are presented in Table 4. Students from governmental universities reported significantly higher levels of motivation, stress, and interaction-related challenges compared to those from private universities. In addition, students residing inside Sudan experienced significantly higher rates of internet challenges than those residing outside Sudan (p = 0.006). Table 4 Prevalence of Challenges by Institution Type and Current Residence of Students. Challenge Institution Type Current Residence Government (%) Private (%) Sig. Inside Sudan Outside Sudan Sig. Internet Connectivity 44.40% 47.90% p=.513 53.30% 38.50% p=.006 Lack of electricity 38.40% 44.30% p=.275 45.60% 37.30% p=.118 Lack of motivation 62.30% 42.70% p<.001 51.10% 51.60% p=.933 Inability to focus due to stress 53.60% 42.70% p=.044 45.60% 49.70% p=.450 Limited interaction with instructors 38.40% 49.50% p=.041 41.20% 48.40% p=.178 Percentages represent the proportion reporting the challenge p statistically significant if <.05. The analysis of the support needed for e-learning was conducted on responses from 301 students and revealed that technical support (e.g., stable internet, electricity, and devices) was mentioned by 127 (42.2%) of students, followed by academic support (e.g., live sessions, assignments, and discussions) by 107 (35.5%). Financial 27 (9%) and clinical 6 (2%) support were the least mentioned categories as visualized in Figure 1. Discussion Due to the persistent conflict and its impact on educational continuity, this study assessed the self-perceived readiness of Sudanese undergraduate dental students during the ongoing war conflict toward E-learning. The specific context in Sudan presents additional challenges for Sudanese university students; therefore, considering students' readiness may contribute to the development of more effective learning strategies. The main findings demonstrated that students exhibited a moderate level of E-learning readiness despite the ongoing war and its negative effects on education. This finding could be attributed to students' familiarity with the E-learning environment throughout the COVID-19 pandemic. However, the overall readiness mean of Sudanese undergraduate dental students was slightly lower than that reported in the studies conducted by others. [9,10] This difference may be related to the persistent challenges created by the war conflict and the preexisting inadequate infrastructure in Sudan. Among the E-learning readiness domains; Online Communication Self-Efficacy (OCS) recorded the highest score, which was in alignment with a previous multi-institution study. [3] This high performance in the OCS among our students could be interpreted by their familiarity with online communication for both social and academic interactions. In contrast, others reported OCS as the lowest domain [9]. The Computer/Internet self-efficacy (CIS) was the second highest perceived readiness domain among our students. A similar finding was reported in another study, [10] whereas a higher level was reported among others. [9] In contrast, a lower level of CIS was observed in the Ethiopian study; [11] however, direct comparison with other studies was not possible as a different measurement scale was used, despite the similarity of the assessed items. These findings indicated an acceptable level of CIS among our students, suggesting that they can perform the basic technical skills required to engage effectively in the E-learning environment. While the present study found no significant difference between Self-Directed Learning (SDL) and Learner Control (LC) indicating that students exhibited similar levels of competency in both domains, the study conducted in Taiwan showed a significant difference between the two domains. [8] However, the moderate levels of these domains in the present study highlighted the need for further development. In contrast to others, [9,10] motivation for learning was the lowest-scoring domain in the present study. Displacement due to the conflict may have contributed to lower students' motivation by causing separation from study partners and loss of daily routine, compared to students in more stable environments as consistent with findings from a previous study. [12] Regarding the type of institution, the findings of this study differ from an Indonesian study, where government universities were found to be better prepared. [13] In our study, the lower level of readiness observed among students enrolled in government universities may be attributed to the fact that these universities experienced multiple prolonged closures during the political instability since 2018 and the COVID-19 pandemic, which likely decreased students’ motivation to continue their education. In agreement with a previous study [14], students residing outside Sudan demonstrated greater E-learning readiness compared to those residing inside Sudan. This may be attributed to better internet access, more stable electricity, and a more stable environment for learning outside Sudan. Concerning the challenges; lack of motivation and inability to focus due to stress may be related to the current war conditions and their negative impact on the learning environment. A similar observation was reported in the Ukrainian study. [15] The poor digital infrastructure remains a major barrier to E-learning before and after war conflict, as reported in several studies conducted during the COVID-19 pandemic. [14,16,17] In alignment with another study, [5] where students faced conditions similar to those in Sudan due to the ongoing conflict; most of students in our study expressed a need for technical support. In alignment with a global pilot study conducted in 2023, [18] concludes; supporting E-learning through assignments, discussions, and live sessions, which enhance students' engagement and recreate classroom-like experiences despite the conflict. Moreover, psychological support may help students in managing distress. Based on the findings of this study, several recommendations were proposed to enhance the effectiveness of the E-learning system. These recommendations include implementation of a hybrid learning model combining live sessions with lecturers to improve students’ commitment, availability of recorded lectures to overcome the poor internet connectivity or power outage, allowing them to download and view the content at a time when their connection was stable. As recommended by others; [19] to maximize effectiveness, this hybrid system should be supported by tutorials and periodic quizzes for assessment, available communication with lecturers for students' questions, and psychological support to help students manage stress, maintain motivation, and adapt to the e-learning challenges. Strengths The required sample size was successfully achieved despite the challenging circumstances created by the ongoing war conflict. Data were collected from students enrolled in different universities ensuring the representation and possibility of generalization of the findings. Moreover the questionnaire was adopted to suit the Sudan context during the ongoing war. Limitations One of the main limitations of this study was the presence of missing data. A total of 12 participants (3.4%) were excluded from the OLRS scale analysis due to the incomplete responses. Since this presence is below 5%, it is considered acceptable. Additionally, some domains of the scale exhibited Cronbach’s alpha below 0.8, which suggested that the OLRS may have limited reliability in areas characterized by instability and war conflict, such as Sudan; compared to previous studies conducted in more stable environments. This observation was consistent with a previous study that reported validity challenges in the application of online learning readiness scales when used in emergency situations. [10] Conclusion This study revealed that Sudanese undergraduate dental students exhibit a moderate level of E-learning readiness. However, poor digital infrastructure remains a major barrier, highlighting the need to adopt flexible learning methods. More future research is needed, including longitudinal studies to evaluate long-term impacts, assessments of faculty and educator readiness, and the impact of E-learning on clinical performance of students. Abbreviations OLRS Online Learning Readiness Scale CIS Computer/Internet Self-efficacy SDL Self-Directed Learning LC Learner's control MFL Motivation For Learning OCS Online Communication Self-efficacy. Declarations Ethical approval and consent to participate : The study was approved by the Ethical Committee from the Faculty of Dentistry, El-Sheikh Abdallah Elbadri University-Berber, Sudan. (No.: EAEU-D‑REC002; 08.2025). All procedures performed in the study were conducted in accordance with the ethical standards given in 1975 Declaration of Helsinki, as revised in 2013. Participation was voluntary and those who agreed, signed informed written consent. Consent to Publish declaration : not applicable. Clinical trial number: not applicable. Availability of data and materials: All data used or analyzed during this study are available from the corresponding author on reasonable request. Competing interests: All authors declared that they have no competing interests. Funding: No funding was received for this study. Authors’ contributions EA : designed the study, literature search, drafting manuscript, revised manuscript. YA : designed the study, literature search, drafting manuscript, and review and editing. SA : performed the data analysis, contributed to the Materials and Methods section, and wrote the Results section. SO : Data collection, data analysis, drafting manuscript, copyediting of the manuscript. All authors have read and approved the manuscript. Acknowledgment: regardless of this very difficult situation facing all Sudanese; undergraduate dental students participated in this study were greatly acknowledged. References Xu, D., & Wang, H. Integration of knowledge management and e-learning. In: Encyclopedia of knowledge management. 2nd ed. IGI Global; 2011:442–451. https://doi.org/10.4018/978-1-59904-933-5.ch189 Mahgoub EAA, Osman S, Haga MB, Khairy A, Osman SHM, Abbu Hassan AM, Ssemwanga N, Elgaali EG, Taha MH. 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Journal of Governance and Public Policy. 2021 Jun 29;8(2):165-83. Ali K, Alhaija ES, Raja M, Zahra D, Brookes ZL, McColl E, Zafar S, Kirnbauer B, Al Wahadni AM, Al-Fodeh RS, Bani-Hani TG. Blended learning in undergraduate dental education: a global pilot study. Medical Education Online. 2023 Dec 31;28(1):2171700. Ahmed A, Dafallah I, Alsayed A. Exploring Medical Students' Perceptions and Preferences for Online Lectures in Sudan. https://doi.org/10.21203/rs.3.rs-5931877/v1 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviewers agreed at journal 18 May, 2026 Reviews received at journal 17 May, 2026 Reviewers agreed at journal 14 May, 2026 Reviewers invited by journal 07 May, 2026 Editor invited by journal 13 Apr, 2026 Editor assigned by journal 09 Apr, 2026 Submission checks completed at journal 09 Apr, 2026 First submitted to journal 02 Apr, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9303721","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":641589757,"identity":"1fb86b1e-9a2a-41c6-be0f-e88757740d14","order_by":0,"name":"Elhadi Mohieldin Awooda","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA6UlEQVRIiWNgGAWjYPACC8YGCR7GB0AWDx+RWiRAWpgNQFrYSNHCJgFiEtQi395j+LmiRkK2f3bvscqvOXYybAzMDx/dwKPF4MwZY8kzxySMZ9w5l3Zbdlsy0GFsxsY5+LRI5G6QbGCTSGy4kWN2W3IbM1ALD5s0Pi3yM3I3/2z4J5E4H6ilWHJbPWEtDDdyt0k2tkkkbgBqYfy47TBhLQZnzn+zbOyTMN54Iy9ZmnHbcR42ZgJ+kW9vS77Z8M1Gdt6N3IMff26rtudnb374GK/DkAEzD5gkVjkIMP4gRfUoGAWjYBSMGAAAkENIUKXK5MYAAAAASUVORK5CYII=","orcid":"","institution":"Elshiekh Abdallah Elbadry University","correspondingAuthor":true,"prefix":"","firstName":"Elhadi","middleName":"Mohieldin","lastName":"Awooda","suffix":""},{"id":641589758,"identity":"d1d44973-1fea-43c5-b0b2-919d9f24f01a","order_by":1,"name":"Yageen Diaeldin Elkheir","email":"","orcid":"","institution":"University of Khartoum","correspondingAuthor":false,"prefix":"","firstName":"Yageen","middleName":"Diaeldin","lastName":"Elkheir","suffix":""},{"id":641589759,"identity":"7240943d-3567-483b-9e3b-b7ab7947be7a","order_by":2,"name":"Samah Mahjoub Albadri","email":"","orcid":"","institution":"University of Khartoum","correspondingAuthor":false,"prefix":"","firstName":"Samah","middleName":"Mahjoub","lastName":"Albadri","suffix":""},{"id":641589760,"identity":"05ddb774-8166-459d-83a8-7235ab7e0b5b","order_by":3,"name":"Safaa Beshir Omer","email":"","orcid":"","institution":"University of Khartoum","correspondingAuthor":false,"prefix":"","firstName":"Safaa","middleName":"Beshir","lastName":"Omer","suffix":""}],"badges":[],"createdAt":"2026-04-02 13:23:22","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9303721/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9303721/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":109446282,"identity":"7fa6ca07-7c69-426a-b0e8-497450a0cade","added_by":"auto","created_at":"2026-05-18 08:21:09","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":56192,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eFrequency of Support Type Mentions Among Students Percentages are based on the number of valid responses for each item (N=301)\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-9303721/v1/b8c70b1cf96c3fd1d5404298.jpg"},{"id":109759590,"identity":"681c6171-09a2-4472-8661-7705caad9d44","added_by":"auto","created_at":"2026-05-22 07:27:23","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":257441,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9303721/v1/4641cf65-c79d-464f-9583-87e9a7d72f75.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Self-Perceived Readiness of Sudanese undergraduate dental students toward E- learning during the ongoing war conflict. A questionnaire-based study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eE-learning is defined as \"an instructional process that gives online learners access to a wide range of resources\u0026mdash;teachers, other learners, and content such as readings and exercises\u0026mdash;independently of place and time.\" [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e] The ongoing conflict in Sudan, which started on April 15, 2023, has impacted higher educational institutions in Khartoum State and beyond, with approximately 79.3% of universities experiencing military attacks. [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e] Higher educational institutions have implemented E-learning as a critical instrument for continuous learning during the ongoing war conflict. Specifically, 44.8% of universities are shifting toward E-learning, ensuring that learning remains uninterrupted and adaptable, despite external disturbances. [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eA recent study in 2024 evaluating dental students\u0026rsquo; readiness for E-learning across six countries showed that Sudanese students scored significantly lower in all five domains of the Online Learning Readiness Scale (OLRS); (self-directed learning, motivation for learning, computer/internet self-efficacy, learner's control, and online communication self-efficacy), and this lower score was attributed to lower financial support for higher education in Sudan. [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e] However, during this war conflict numerous challenges hinder an effective shift to E-learning, including unreliable electricity, poor Internet connectivity, and inadequate digital infrastructure, [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e] similar to others with the same situation. [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eIn Sudan, many studies were conducted during the COVID-19 pandemic. Still, there remains a notable gap in studies assessing the readiness of university students in the Sudanese context, where the ongoing war has displaced students both internally and externally, leading to variations in their learning environments. Therefore, the main objective of this study was to assess the self-perceived readiness for E-learning among Sudanese undergraduate dental students, while the specific objectives were to identify key barriers facing students learning readiness during war conflict. Also, to compare findings of the Online Learning Readiness Scale (OLRS) between students from private and government universities, and between those who reside outside and those inside Sudan.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003e\u003cstrong\u003eEthical Approval:\u0026nbsp;\u003c/strong\u003eThe study was approved by the Ethical Committee from the Faculty of Dentistry, El-Shiekh Abdallah Elbadry University-Berber, Sudan. (No.: EAEU-D‑REC002; 08.2025). All procedures performed in the study were conducted in accordance with the ethical standards given in 1975 Declaration of Helsinki, as revised in 2013.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eParticipation was voluntary, informed signed online consent was obtained, and the anonymity of participants was ensured.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy design, Area and Duration:\u0026nbsp;\u003c/strong\u003eA descriptive cross-sectional study was conducted among undergraduate dental students of fifteen (governmental and private) universities, where thirteen were from Khartoum state and two from El-Gezira state, which were affected at the beginning of the ongoing conflict. The study duration was between August 2025 and September 2025.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy population:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study targeted third-, fourth-, and fifth-year dental students because of their higher academic maturity, greater exposure to both traditional and E-learning methods, and consistent attendance during the conflict period. First and second students, graduates and those who did not attend E-learning where excluded.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSample size and technique:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe total number of students from the third-, fourth-, and fifth-year was 4,186. Accordingly, the required sample size, calculated using Cochran\u0026apos;s formula, [7] was 352.\u003cspan dir=\"RTL\"\u003e\u0026nbsp;\u003c/span\u003eThe sample was proportionally distributed according to the stratification of the universities, applying a stratified random sampling technique to ensure representative participation from all the universities.\u003c/p\u003e\n\u003cp\u003eAfter determining the number of participants required from each university, students were invited to complete the questionnaire using Google Forms, which were distributed online through their WhatsApp accounts. Participants were also encouraged to share the questionnaire with colleagues to reach the intended sample size. Non probability sampling was adopted because of limited\u003cspan dir=\"RTL\"\u003e\u0026nbsp;\u003c/span\u003eaccess to students, many of whom had been displaced by the ongoing conflict, making direct contact with all participants challenging. This combination of stratified and convenience sampling ensured both representativeness and an efficient data collection.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData collection tool and procedure:\u0026nbsp;\u003c/strong\u003eA structured questionnaire based on the validated Online Learning Readiness Scale .(OLRS) [8] The instrument assesses five domains: Self-Directed Learning (SDL), Motivation for Learning (MFL), Computer/Internet Self-Efficacy (CIS), Learner\u0026rsquo;s Control (LC), and Online Communication Self-Efficacy (OCS). The questionnaire was adapted from a previous study, [3] with some modifications to suit the ongoing conflict situation.\u003c/p\u003e\n\u003cp\u003eThe final questionnaire consisted of three sections: Section A: demographic data (sex, type of institution, academic year, and current residence). Section B: The Online Learning Readiness Scale (OLRS) consisted of sixteen items (five questions measured computer/internet self-efficacy (CIS; Cronbach\u0026rsquo;s \u0026alpha; = 0.65), three questions measured self-directed learning (SDL; Cronbach\u0026rsquo;s \u0026alpha; = 0.63), three questions measured learner\u0026apos;s control (LC; Cronbach\u0026rsquo;s \u0026alpha; = 0.68), three questions measured motivation for learning (MFL: Cronbach\u0026rsquo;s \u0026alpha; = 0.75), and two questions measured online communication self-efficacy (OCS: Cronbach\u0026rsquo;s \u0026alpha; = 0.63). Section C: Barriers to online learning during the conflict.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData analysis:\u0026nbsp;\u003c/strong\u003eThe collected data were analyzed using IBM SPSS Statistics version 29.0 (IBM Corp., Illoins, USA). Descriptive statistics, including frequencies, percentages, means, and standard deviations, were calculated to summarize participants\u0026rsquo; demographic characteristics and domain scores. A one-sample t-test compared the mean total readiness score with the theoretical neutral point, and chi-square tests examined differences in reported challenges across demographic groups.\u003c/p\u003e\n\u003cp\u003eTo compare readiness levels across the five domains, a repeated-Measures ANOVA was performed. Mauchly\u0026rsquo;s Test indicated a violation of sphericity (p \u0026lt; 0.001), so the Greenhouse-Geisser correction was applied. Despite significant deviations from normality in the Kolmogorov\u0026ndash;Smirnov and Shapiro\u0026ndash;Wilk tests (p \u0026lt; 0.05), the large sample size (n = 355) supported the use of parametric analysis based on the Central Limit Theorem. Significant effects were further examined using Bonferroni-adjusted post-hoc pairwise comparisons. The significance level was set at p \u0026lt; 0.05.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe response rate was (96.6%), with 343 of 355 dental students included in the e-learning readiness (OLRS scale) analysis. These students where included after 12 participants were excluded due to missing data in the scale items. The demographic analysis indicated that the majority of participants were female students 290 (81.7%), while the remaining demographic data were detailed in Table 1.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;Table\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003cstrong\u003e\u003cspan dir=\"RTL\"\u003e \u003c/span\u003e\u003c/strong\u003e\u003cstrong\u003eSample Characteristics of Sudanese Dental Students (N=355)\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" title=\"Table. 1 Sample Characteristic of Sudanese Dental Students (N=355)\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003eCharacteristic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003eCategory\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003eFrequency (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eSex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003e290 (81.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003e65 (18.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eInstitution Type\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003eGovernment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003e156 (43.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003ePrivate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003e199 (56.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003eCurrent Residence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003eInside Sudan\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003e191 (53.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003eOutside Sudan\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003e164 (46.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eStudy Year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003e3\u003csup\u003erd\u003c/sup\u003e Year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003e88 (24.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003e4\u003csup\u003eth\u003c/sup\u003e Year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003e158 (44.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003e5\u003csup\u003eth\u003c/sup\u003e Year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003e109 (30.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eThe overall e-Learning readiness among Sudanese dental students was significantly (t (342) = 10.19) above the midpoint of 3.0 (M = 3.34 \u0026plusmn;0.62, 95% CI [3.27, 3.41]).\u003c/p\u003e\n\u003cp\u003eThe analysis revealed a statistically significant difference among the mean scores of the five e-learning readiness domains (F (3.51, 1199.91) = 161.89, p \u0026lt; 0.001, partial = 0.321). The Online Communications Skills (OCS) domain had the highest mean score (M = 3.895), significantly (p \u0026lt; 0.001) higher than all other domains. Motivation for Learning (MFL) had the lowest mean score (M = 2.787). Self-Directed Learning (SDL) and Learner Control (LC) were the only two domains that didn\u0026rsquo;t show a statistically significant difference as detailed in Table 2.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e2\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;Comparative Analysis of E-learning Readiness across the Five Online \u0026nbsp; \u0026nbsp; \u0026nbsp;Learning Readiness Domains\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" title=\"Table. 1 Sample Characteristic of Sudanese Dental Students (N=355)\" align=\"\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eOnline Learning Readiness Domains\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003eStd. Deviation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003e95% Confidence interval\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003eSignificant Differences\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eOCS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e3.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003e0.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003e[3.801, 3.989]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003ea\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eCIS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e3.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003e0.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003e[3.534, 3.696]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003eb\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eSDL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e3.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003e0.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003e[3.109, 3.293]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003ec\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eLC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e3.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003e0.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003e[3.106, 3.296]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003ec\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eMFL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e2.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003e0.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003e[2.710, 2.865]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003ed\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eMeans in the same column do not share a common superscript letter (a, b, c, d) are statistically significantly different from each other at p\u0026lt;.05 level. OCS= Online Communication Skills, CIS= Computer/ Internet self-efficacy, SDL= Self-directed Learning, LC= Learning control, MFL= Motivation for Learning.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAs shown in Table 3, e-learning readiness was significantly higher among students from private universities and those outside Sudan, with no significant difference for previous e-learning experience or academic year. The relationship between students\u0026rsquo; readiness scores and their access to a quiet and safe environment for e-learning indicated no significant correlation between the two variables, \u0026rho; (341) = 0.12, p = 0.829.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;Table\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e3\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;Comparison of E-learning Readiness Across students Characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" align=\"\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eCharacteristic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eComparison\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eMean (M)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eUniversity Type\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003ePrivate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e3.44\u0026plusmn;0.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eGovernment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e3.21\u0026plusmn;0.59\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eCurrent residence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eOutside Sudan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e3.42\u0026plusmn;0.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0.019\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eInside Sudan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e3.27\u0026plusmn;0.63\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eE-learning Experience\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e3.34\u0026plusmn;0.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0.906\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e3.33\u0026plusmn;0.59\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eAcademic Year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e3\u003csup\u003erd\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e3.27\u0026plusmn;0.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0.463\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e4\u003csup\u003eth\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e3.34\u0026plusmn;0.56\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e5\u003csup\u003eth\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e3.39\u0026plusmn;0.60\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eA p-value ˂ 0.05 indicates Statistical significance.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe most prevalent challenge associated with e-learning was lack of motivation 184 (51.8%). This was followed by an inability to focus due to stress as reported by 168 (47.3%). Additionally, a considerable number of students, 165 (46.5%), identified poor internet connectivity and limited interactions with instructors, 156(43.9%), as key barriers. Lastly, 146 (41.1%) of students had electricity challenges. Variations in the prevalence of the reported challenges across institution type and the current residence of students the findings are presented in Table 4. Students from governmental universities reported significantly higher levels of motivation, stress, and interaction-related challenges compared to those from private universities. In addition, students residing inside Sudan experienced significantly higher rates of internet challenges than those residing outside Sudan (p = 0.006).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e4\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;Prevalence of Challenges by Institution Type and Current Residence of Students.\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" align=\"\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 147px;\"\u003e\n \u003cp\u003eChallenge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 222px;\"\u003e\n \u003cp\u003eInstitution Type\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003eCurrent Residence\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003eGovernment (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003ePrivate (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003eSig.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003eInside Sudan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003eOutside Sudan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003eSig.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 147px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eInternet Connectivity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e44.40%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e47.90%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003ep=.513\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e53.30%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e38.50%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003ep=.006\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 147px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLack of electricity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e38.40%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e44.30%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003ep=.275\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e45.60%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e37.30%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003ep=.118\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 147px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLack of motivation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e62.30%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e42.70%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003ep\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e51.10%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e51.60%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003ep=.933\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 147px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eInability to focus due to stress\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e53.60%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e42.70%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003ep=.044\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e45.60%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e49.70%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003ep=.450\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 147px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLimited interaction with instructors\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e38.40%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e49.50%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003ep=.041\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e41.20%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e48.40%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003ep=.178\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003ePercentages represent the proportion reporting the challenge\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003ep statistically significant if \u0026lt;.05.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe analysis of the support needed for e-learning was conducted on responses from 301 students and revealed that technical support (e.g., stable internet, electricity, and devices) was mentioned by 127 (42.2%) of students, followed by academic support (e.g., live sessions, assignments, and discussions) by 107 (35.5%). Financial 27 (9%) and clinical 6 (2%) support were the least mentioned categories as visualized in Figure 1.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003e\u0026nbsp;Due to the persistent conflict and its impact on educational continuity, this study assessed the self-perceived readiness of Sudanese undergraduate dental students during the ongoing war conflict toward E-learning. The specific context in Sudan presents additional challenges for Sudanese university students; therefore, considering students\u0026apos; readiness may contribute to the development of more effective learning strategies.\u003c/p\u003e\n\u003cp\u003eThe main findings demonstrated that students exhibited a moderate level of E-learning readiness despite the ongoing war and its negative effects on education. This finding could be attributed to students\u0026apos; familiarity with the E-learning environment throughout the COVID-19 pandemic. However, the overall readiness mean of Sudanese undergraduate dental students was slightly lower than that reported in the studies conducted by others. [9,10] This difference may be related to the persistent challenges created by the war conflict and the preexisting inadequate infrastructure in Sudan.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAmong the E-learning readiness domains; Online Communication Self-Efficacy (OCS) recorded the highest score, which was in alignment with a previous multi-institution study. [3] This high performance in the OCS among our students could be interpreted by their familiarity with online communication for both social and academic interactions. In contrast, others reported OCS as the lowest domain [9].\u003c/p\u003e\n\u003cp\u003eThe Computer/Internet self-efficacy (CIS) was the second highest perceived readiness domain among our students. A similar finding was reported in another study, [10] whereas a higher level was reported among others. [9] In contrast, a lower level of CIS was observed in the Ethiopian study; [11] however, direct comparison with other studies was not possible as a different measurement scale was used, despite the similarity of the assessed items. These findings indicated an acceptable level of CIS among our students, suggesting that they can perform the basic technical skills required to engage effectively in the E-learning environment.\u003c/p\u003e\n\u003cp\u003eWhile the present study found no significant difference between Self-Directed Learning (SDL) and Learner Control (LC) indicating that students exhibited similar levels of competency in both domains, the study conducted in Taiwan showed a significant difference between the two domains. [8] However, the moderate levels of these domains in the present study highlighted the need for further development.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn contrast to others, [9,10] motivation for learning was the lowest-scoring domain in the present study. Displacement due to the conflict may have contributed to lower students\u0026apos; motivation by causing separation from study partners and loss of daily routine, compared to students in more stable environments as consistent with findings from a previous study. [12]\u003c/p\u003e\n\u003cp\u003eRegarding the type of institution, the findings of this study differ from an Indonesian study, where government universities were found to be better prepared. [13] In our study, the lower level of readiness observed among students enrolled in government universities may be attributed to the fact that these universities experienced multiple prolonged closures during the political instability since 2018 \u0026nbsp;and the COVID-19 pandemic, which likely decreased students\u0026rsquo; motivation to continue their education.\u003c/p\u003e\n\u003cp\u003eIn agreement with a previous study [14], students residing outside Sudan demonstrated greater E-learning readiness compared to those residing inside Sudan. This may be attributed to better internet access, more stable electricity, and a more stable environment for learning outside Sudan.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eConcerning the challenges; lack of motivation and inability to focus due to stress may be related to the current war conditions and their negative impact on the learning environment. A similar observation was reported in the Ukrainian study. [15] The poor digital infrastructure remains a major barrier to E-learning before and after war conflict, as reported in several studies conducted during the COVID-19 pandemic. [14,16,17]\u003c/p\u003e\n\u003cp\u003eIn alignment with another study, [5] where students faced conditions similar to those in Sudan due to the ongoing conflict; most of students in our study expressed a need for technical support. In alignment with a global pilot study conducted in 2023, [18] concludes; supporting E-learning through assignments, discussions, and live sessions, which enhance students\u0026apos; engagement and recreate classroom-like experiences despite the conflict. Moreover, psychological support may help students in managing distress.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eBased on the findings of this study, several recommendations were proposed to enhance the effectiveness of the E-learning system. These recommendations include implementation of a hybrid learning model combining live sessions with lecturers to improve students\u0026rsquo; commitment, availability of recorded lectures to overcome the poor internet connectivity or power outage, allowing them to download and view the content at a time when their connection was stable. As recommended by others; [19] to maximize effectiveness, this hybrid system should be supported by tutorials and periodic quizzes for assessment, available communication with lecturers for students\u0026apos; questions, and psychological support to help students manage stress, maintain motivation, and adapt to the e-learning challenges.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStrengths\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe required sample size was successfully achieved despite the challenging circumstances created by the ongoing war conflict. Data were collected from students enrolled in different universities ensuring the representation and possibility of generalization of the findings. Moreover the questionnaire was adopted to suit the Sudan context during the ongoing war. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLimitations\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOne of the main limitations of this study was the presence of missing data. A total of 12 participants (3.4%) were excluded from the OLRS scale analysis due to the incomplete responses. Since this presence is below 5%, it is considered acceptable. Additionally, some domains of the scale exhibited Cronbach\u0026rsquo;s alpha below 0.8, which suggested that the OLRS may have limited reliability in areas characterized by instability and war conflict, such as Sudan; compared to previous studies conducted in more stable environments. This observation was consistent with a previous study that reported validity challenges in the application of online learning readiness scales when used in emergency situations. [10]\u003c/p\u003e"},{"header":"Conclusion ","content":"\u003cp\u003eThis study revealed that Sudanese undergraduate dental students exhibit a moderate level of E-learning readiness. However, poor digital infrastructure remains a major barrier, highlighting the need to adopt flexible learning methods.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMore future research is needed, including longitudinal studies to evaluate long-term impacts, assessments of faculty and educator readiness, and the impact of E-learning on clinical performance of students.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eOLRS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eOnline Learning Readiness Scale\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCIS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eComputer/Internet Self-efficacy\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSDL\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eSelf-Directed Learning\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eLC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eLearner's control\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMFL\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eMotivation For Learning\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eOCS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eOnline Communication Self-efficacy.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical approval\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eand consent to participate\u003c/strong\u003e\u003cstrong\u003e:\u003c/strong\u003e The study was approved by the Ethical Committee from the Faculty of Dentistry, El-Sheikh Abdallah Elbadri University-Berber, Sudan. (No.: EAEU-D‑REC002; 08.2025). All procedures performed in the study were conducted in accordance with the ethical standards given in 1975 Declaration of Helsinki, as revised in 2013. Participation was voluntary and those who agreed, signed informed written consent.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to Publish declaration\u003c/strong\u003e: not applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number:\u003c/strong\u003e not applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll data used or analyzed during this study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests:\u0026nbsp;\u003c/strong\u003eAll authors declared that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u0026nbsp;\u003c/strong\u003eNo funding was received for this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEA\u003c/strong\u003e: designed the study, literature search, drafting manuscript, revised manuscript. \u003cstrong\u003eYA\u003c/strong\u003e: designed the study, literature search, drafting manuscript, and review and editing. \u003cstrong\u003eSA\u003c/strong\u003e: performed the data analysis, contributed to the Materials and Methods section, and wrote the Results section. \u003cstrong\u003eSO\u003c/strong\u003e: Data collection, data analysis, drafting manuscript, copyediting of the manuscript. \u0026nbsp; All authors have read and approved the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgment:\u0026nbsp;\u003c/strong\u003eregardless of this very difficult situation facing all Sudanese; undergraduate dental students participated in this study were greatly acknowledged.\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eXu, D., \u0026amp; Wang, H. Integration of knowledge management and e-learning. In: Encyclopedia of knowledge management. 2nd ed. IGI Global; 2011:442\u0026ndash;451. https://doi.org/10.4018/978-1-59904-933-5.ch189 \u003c/li\u003e\n\u003cli\u003eMahgoub EAA, Osman S, Haga MB, Khairy A, Osman SHM, Abbu Hassan AM, Ssemwanga N, Elgaali EG, Taha MH. Dental education amid armed conflict in Sudan: Unveiling the impact on training. PLoS One. 2024 Oct 9;19(10):e0311583. doi: 10.1371/journal.pone.0311583. PMID: 39383150; PMCID: PMC11463757.\u003c/li\u003e\n\u003cli\u003eAlmahdi HM, Elhag AK, Ibrahim AIO, Suliman NMA, Ahmed MA, Bello SM. E-learning Self-Perceived Readiness Among Dental Students: A Multi-Institution Study. Med Forum 2024;35(8):27-32. doi:10.60110/medforum.350806.\u003c/li\u003e\n\u003cli\u003eAlcaide JC. A University College Working in the Midst of the War in Sudan Through Digital Education. Social Education Research. 2025;1:180-98.\u003c/li\u003e\n\u003cli\u003eKhasawneh R, Alsharif B and Khasawneh R. Online learning amidst crisis: perceptions of Gazan university students. Front. Educ. 2025;10:1659256. doi: 10.3389/feduc.2025.1659256 \u003c/li\u003e\n\u003cli\u003eMualla W, Mualla KJ. Higher education in Syria post-war and pandemic: challenges and opportunities. Higher Education in the Arab World: New Priorities in the Post COVID-19 Era. 2022 Sep 30:283-309.\u003c/li\u003e\n\u003cli\u003eCochran WG. Sampling techniques. john wiley \u0026amp; sons; 1977.\u003c/li\u003e\n\u003cli\u003eHung ML, Chou C, Chen CH, Own ZY. Learner readiness for online learning: Scale development and student perceptions. Computers \u0026amp; Education. 2010 Nov 1; 55(3):1080-90.\u003c/li\u003e\n\u003cli\u003eChung E, Noor NM, Mathew VN. Are you ready? An assessment of online learning readiness among university students. International Journal of Academic Research in Progressive Education and Development. 2020; 9(1):301-17.\u003c/li\u003e\n\u003cli\u003eRafique GM, Mahmood K, Warraich NF, Rehman SU. Readiness for Online Learning during COVID-19 pandemic: A survey of Pakistani LIS students. The Journal of Academic Librarianship. 2021 May 1;47(3):102346.\u003c/li\u003e\n\u003cli\u003eDejene W, Tilahun D. How ready are our students for e-learning? Evidence from Ethiopia. Discover Education. 2024 Dec 20;3(1):283.\u003c/li\u003e\n\u003cli\u003eAlamin NK, Idris AA, Khugali G, Kalcon GO, Khaleel M, Alamin KN. Science in times of war: reflections from Sudan. ASFI Research Journal. 2024;1(1):e13267.\u003c/li\u003e\n\u003cli\u003eSaintika Y, Astiti S, Kusuma DJ, Muhammad AW. Analysis of e-learning readiness level of public and private universities in Central Java, Indonesia. Register: Jurnal Ilmiah Teknologi Sistem Informasi. 2021 Jan 23;7(1):16-30.\u003c/li\u003e\n\u003cli\u003eGismalla MD, Mohamed MS, Ibrahim OS, Elhassan MM, Mohamed MN. Medical students\u0026rsquo; perception towards E-learning during COVID 19 pandemic in a high burden developing country. BMC Medical Education. 2021 Jul 10;21(1):377.\u003c/li\u003e\n\u003cli\u003eKaminskyy V. The role of e-learning during martial law: The Ukrainian experience. E-Learning Innovations Journal. 2024 Sep 25;2(2):52-79.\u003c/li\u003e\n\u003cli\u003eSeed Ahmed M, Soltani A, Zahra D, Allouch S, Al Saady RM, Nasr A, Saleh N, Saeed A, Awad KA, Baraka SA, Ahmed O. Remote online learning reimagined: perceptions and experiences of medical students in a post-pandemic world. BMC Medical Education. 2025 Feb 10;25(1):215.\u003c/li\u003e\n\u003cli\u003eIbrahim AH, Mutiarin D, Purnomo EP. E-services in Sudan during the Covid-19 pandemic as a model: a case study of university of Bahri-Sudan. Journal of Governance and Public Policy. 2021 Jun 29;8(2):165-83.\u003c/li\u003e\n\u003cli\u003eAli K, Alhaija ES, Raja M, Zahra D, Brookes ZL, McColl E, Zafar S, Kirnbauer B, Al Wahadni AM, Al-Fodeh RS, Bani-Hani TG. Blended learning in undergraduate dental education: a global pilot study. Medical Education Online. 2023 Dec 31;28(1):2171700.\u003c/li\u003e\n\u003cli\u003eAhmed A, Dafallah I, Alsayed A. Exploring Medical Students\u0026apos; Perceptions and Preferences for Online Lectures in Sudan. https://doi.org/10.21203/rs.3.rs-5931877/v1\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Online learning, Virtual learning, Interactive lecture, Self-directed learning","lastPublishedDoi":"10.21203/rs.3.rs-9303721/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9303721/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eE-Learning is defined as a learning method that uses digital technologies and the internet to deliver educational content anytime and anywhere. This study aimed to assess the self-perceived readiness of Sudanese undergraduate dental students toward E-learning during the ongoing war conflict.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA descriptive cross-sectional study was conducted among 355 (third, fourth, and fifth years\u0026rsquo;) undergraduate dental students residing inside and outside Sudan. They were selected from fifteen private and governmental dental schools, in the period between August and September 2025 during the ongoing war conflict in Sudan. A Google Form questionnaire was distributed online through students' Watts Up groups. It included demographic data and the Online Learning Readiness Scale (OLRS) with some modifications. Data were analyzed by t-test and ANOVA for parametric data, and chi-square test for nonparametric data, with the level of statistical significance set at P\u0026thinsp;=\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe response rate was 343 (96.6%), E-learning readiness was above the midpoint (M\u0026thinsp;=\u0026thinsp;3.34\u0026thinsp;\u0026plusmn;\u0026thinsp;0.62). Online Communication Skills was the highest domain (M\u0026thinsp;=\u0026thinsp;3.90\u0026thinsp;\u0026plusmn;\u0026thinsp;0.88), while Motivation for Learning was the lowest domain (M\u0026thinsp;=\u0026thinsp;2.79\u0026thinsp;\u0026plusmn;\u0026thinsp;0.73). Private university students showed higher readiness (M\u0026thinsp;=\u0026thinsp;3.44\u0026thinsp;\u0026plusmn;\u0026thinsp;0.62) than government one (M\u0026thinsp;=\u0026thinsp;3.21\u0026thinsp;\u0026plusmn;\u0026thinsp;0.59). Similarly, students residing outside Sudan had significantly higher readiness (M\u0026thinsp;=\u0026thinsp;3.42\u0026thinsp;\u0026plusmn;\u0026thinsp;0.59) compared to those inside Sudan (M\u0026thinsp;=\u0026thinsp;3.27\u0026thinsp;\u0026plusmn;\u0026thinsp;0.63). The major challenges reported included lack of motivation (51.8%), inability to focus due to stress (47.3%), and electricity challenges (41.1%). Students expressed the need for technical (42.2%), academic (35.5%), interactive sessions (25.9%), and psychological support (15%) to enhance their e-learning experience.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eSudanese undergraduate dental students demonstrated an acceptable level of E-learning readiness despite the challenges. Persistent challenges related to digital infrastructure continue to hinder the effectiveness of E-learning. However, further improvements are required to enhance education.\u003c/p\u003e","manuscriptTitle":"Self-Perceived Readiness of Sudanese undergraduate dental students toward E- learning during the ongoing war conflict. A questionnaire-based study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-05-18 08:21:00","doi":"10.21203/rs.3.rs-9303721/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"57850640366863080669586264557473896772","date":"2026-05-18T05:17:27+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-17T07:10:50+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"121255664301537149507703487364060734070","date":"2026-05-14T19:32:00+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-05-07T16:52:38+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-04-13T10:06:40+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-04-10T03:07:35+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-04-10T03:06:59+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Medical Education","date":"2026-04-02T13:06:28+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"e71028dc-036f-4816-940d-5fa4c666b32a","owner":[],"postedDate":"May 18th, 2026","published":true,"recentEditorialEvents":[{"type":"reviewerAgreed","content":"57850640366863080669586264557473896772","date":"2026-05-18T05:17:27+00:00","index":61,"fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-17T07:10:50+00:00","index":60,"fulltext":""},{"type":"reviewerAgreed","content":"121255664301537149507703487364060734070","date":"2026-05-14T19:32:00+00:00","index":58,"fulltext":""},{"type":"reviewersInvited","content":"30","date":"2026-05-07T16:52:38+00:00","index":"","fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-05-18T08:21:00+00:00","versionOfRecord":[],"versionCreatedAt":"2026-05-18 08:21:00","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9303721","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9303721","identity":"rs-9303721","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}