Comparing the Effectiveness of in-person in country and synchronous virtually online for Cambodia’s Rehabilitation Health Workforce

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Given the necessity to strengthen health workforce capacity in developing countries, this study provides insights into the effectiveness of training delivery modes to improve rehabilitation healthcare personnel training. Methods A quantitative study was conducted to evaluate learning satisfaction, incorporating both structured survey responses and anecdotal comments from open-ended questions. The study employed a validated learning satisfaction tool, adjusted for reliability and validity. In the synchronous virtually online training sessions, an online survey using a 5-point Likert scale was conducted, while in the in-person in-country training sessions, data were collected through direct surveys. Study participants were selected using convenience sampling. Results Male participants comprised 60% of the total, while 80% were affiliated with the Khmer-Soviet Friendship Hospital. Additionally, 65% were physical therapists, and 55% had at least 10 years of experience. The findings indicated higher satisfaction in in-person in country, attributed to increased interaction and real-time feedback(Q4: t = 2.413, p = 0.021; Q10: t = 3.285, p = 0.002). However, synchronous virtually online was preferred by trainees for its flexibility. Additionally, conducting the program in the Cambodian native language considerably enhanced trainee satisfaction. Conclusions This study highlights the strengths and limitations of different educational delivery methods in healthcare workforce training. It suggests that a hybrid approach, incorporating both in-person in country and synchronous virtually online in trainees' native language, may optimize learning satisfaction and engagement in future programs. Cambodian trainees Dr. LEE Jong-wook Fellowship Health workforce training In-person in country Rehabilitation Synchronous virtually online 1. Introduction With the growing emphasis on workforce development and training in recipient countries for international development cooperation, the importance of invitation-based training in official development assistance (ODA) has been increasing. Furthermore, since the 2000s, the World Health Organization (WHO) has formulated strategies to strengthen and develop healthcare workforce capacity. 1) According to the 2013 comprehensive evaluation of invitation-based training by the Korea Institute of Public Administration, a total of KRW(Korean Won) 239 billion was allocated from 2010 to 2012 for invitation-based training projects involving 22,527 trainees from 169 countries. 2) The Korea International Cooperation Agency (KOICA), which accounts for approximately half of Korea's invitation training budget, spent KRW 3.9 billion for these programs. 3) As a public institution under the Ministry of Health and Welfare, the Korea Foundation for International Healthcare (KOFIH) has implemented various training programs tailored to partner countries' needs, focusing on the Dr. LEE Jong-wook Fellowship Program since 2007. The Dr. LEE Jong-wook Fellowship Program has hosted 1,500 trainees from 30 countries by 2024, with 161 trainees participating in 2023 alone and a budget of KRW 8.7 billion allocated for the year. Among these programs, the invitation-based training program for rehabilitation healthcare workforce development was first piloted in 2019 through collaboration between KOFIH and the Korea National Rehabilitation Center. 4) From 2019 to 2024, a total of five sessions, including local training, were conducted, with 43 trainees completing the course. This program aims to train healthcare professionals from developing countries and contribute to strengthening their national healthcare services and healthcare systems by establishing networks and partnerships. To maximize the effectiveness of invitation-based training programs and strengthen healthcare workforce capacity, it is essential to analyze educational needs by surveying participants' perceptions and preferences and provide training programs focused on field-specific tasks and problem-solving. 5) Particularly in healthcare education, where practical training based on theoretical knowledge is critical, in-eprson education has been emphasized. 6) However, with the COVID-19 pandemic, a rapid shift from in-person to synchronous virtually online occurred, highlighting the global importance of online education. This shift has not involved merely a technical change but has considerably affected learners' satisfaction and educational effectiveness. 7) Many studies have explored the effectiveness of in-person and synchronous virtually online. synchronous virtually online offers advantages such as freedom from time and location constraints, and learners can control their learning environment and methods. 8) However, it tends to be unidirectional, making it challenging to adjust the teaching pace or intensity based on learners' questions or reactions as in in-person settings. 9) Additionally, interaction between instructors and learners decreases, whereas diverse activities outside of lessons rarely occur. 10) By contrast, in-person education enables immediate feedback and hands-on learning. 11) It also promotes social interaction among learners, enhancing their motivation and performance. However, the drawbacks of in-person education include time and location constraints and the difficulty of efficiently delivering educational content to large groups. 12) In healthcare education, including rehabilitation, acquiring skills through practical experience is essential, which underscores the importance of in-person education while discussing the limitations of synchronous virtually online education. Nevertheless, the shift to synchronous virtually online education has become necessary, requiring research on differences in learning satisfaction due to this transition. 6) Additionally, synchronous online sessions, which allow real-time interaction between instructors and learners, present both advantages and challenges. While they enable immediate feedback and maintain a structured learning pace, they may still lack the hands-on experience crucial for skill acquisition in rehabilitation training. Therefore, further analysis is needed to evaluate their effectiveness in comparison to in-perosn and asynchronous learning methods. Given this context, this study aimed to compare and analyze learning satisfaction between in-person and synchronous virtually online education among Cambodian trainees participating in the rehabilitation program of the Dr. LEE Jong-wook Fellowship. It sought to identify differences in effectiveness based on the mode of delivery and contribute to proposing future directions for rehabilitation health workforce training programs. 2. Methods 1) Study Participants The "Dr. LEE Jong-wook Fellowship Clinical Program (Cambodian Rehabilitation)" conducted by KOFIH was operated by the Korea National Rehabilitation Center under a commissioned contract. The analysis in this study is based on the 2023 program outcome report. The study included 21 Cambodian rehabilitation healthcare professionals who participated in the 2023 Dr. LEE Jong-wook Fellowship Program. Participants were not randomly selected; instead, they were chosen based on specific inclusion criteria, including English proficiency, employment at a Cambodian national hospital, and their professional role as a doctor, nurse, or physical therapist. The exclusion criterion is rehabilitation healthcare personnel working in private hospitals rather than national hospitals. These criteria were established to ensure that trainees could effectively engage in the program and apply the acquired knowledge in their respective healthcare settings. The program was divided into in-person and synchronous virtually online education sessions. The synchronous virtually online education consisted of three sessions, each lasting three hours, totaling nine hours, whereas the in-person education comprised three sessions, each lasting four hours, totaling twelve hours. The training was divided into three categories: general education, specialized theory, and specialized practice. The general education included topics such as the history of rehabilitation in Korea, the Korean health insurance system, and Korean language education. The specialized theory and practice sessions were conducted by experts in each field, including physicians, nurses, and physical therapists. 2) Research Tools The survey was developed by modifying and supplementing the questionnaire designed in the "Development of New Performance Indicators for the KOFIH Dr. LEE Jong-wook Fellowship Program" study 13) to align with the purpose of this research. The questionnaire comprised 15 items, including 4 items on general characteristics, 10 multiple-choice items on learning satisfaction, and 1 open-ended item on learning satisfaction. The general characteristics section surveyed gender, affiliated institution, job type, and career experience. The multiple-choice items on learning satisfaction assessed the usefulness of learning, its applicability to work, learning methods, media selection, learning level, and satisfaction with communication. The questionnaire used a five-point Likert scale (strongly disagree, disagree, neutral, agree, strongly agree) and was scored from 0 to 50, with higher scores indicating higher learning satisfaction. The open-ended question on learning satisfaction allowed participants to describe in their own words their satisfaction or dissatisfaction with the training. The survey was conducted after explaining its content to the participants and obtaining their consent. Participants who engaged in in-person education completed the survey in person using a self-administered format, whereas those in synchronous virtually online training completed the survey via Google Forms. The survey was conducted immediately after the final session of each type of training (IRB-NRC-2024-04-024). 3) Statistical Methods Data collected in the study were analyzed using the IBM SPSS Statistics 27. Frequency analysis was used to determine the general characteristics of the participants, whereas descriptive statistics were employed to analyze the mean and standard deviation of the main variables measured. To verify the suitability of the questionnaire items, validity and reliability analyses were conducted, and differences in learning satisfaction between the in-person educaiton and synchronous virtually online groups were analyzed using an independent t-test. Pearson's correlation analysis was performed to examine the relationship between the main variables and learning satisfaction. Additionally, factors influencing learning satisfaction were interpreted using content analysis, one of the qualitative research methods, based on responses to the open-ended question. The content analysis was conducted based on the participants' written responses to the open-ended question. 4)14) 3. Results 1) General Characteristics of Participants The general characteristics of the participants are shown in Table 1 . Male participants accounted for 60%, participants affiliated with the Khmer-Soviet Friendship Hospital for 80%, physical therapists for 65%, and participants with at least 10 years of experience for 55% of the total. Table 1 Personal characteristics of participants (N = 21) Characteristic Category N (%) Gender Male 12(57) Female 9(43) Affiliation Khmer-Soviet Friendship Hospital 17(80) Battambang Hospital 2(10) National Pediatric Hospital 1(5) Others 1(5) Occupation Physician 3(14) Nurse 5(25) Physical Therapist 13(61) Career Experience Less than 10 years 10(47) 10 years or more 11(53) 2) Descriptive Statistics for Main Variables Descriptive statistics for the main variables are shown in Table 2 . The highest average scores were for Q2 (mean 4.36, SD = 0.54) and Q3 (mean 4.36, SD = 0.58), whereas the lowest score was for Q10 (mean 4.00, SD = 0.63). The highest standard deviation was for Q9 (mean 4.09, SD = 0.80), and the lowest standard deviation was for Q5 (mean 4.14, SD = 0.42). Table 2 Descriptive Statistics for Main Variables Questions Minimum Maximum Mean SD values Q1 1.00 5.00 4.12 0.71 Q2 3.00 5.00 4.36 0.54 Q3 3.00 5.00 4.36 0.58 Q4 3.00 5.00 4.17 0.63 Q5 3.00 5.00 4.14 0.42 Q6 2.00 5.00 3.90 0.54 Q7 2.00 5.00 4.09 0.62 Q8 3.00 5.00 4.14 0.65 Q9 2.00 5.00 4.09 0.80 Q10 3.00 5.00 4.00 0.63 Q1: My professor's teaching and advice related to my specialty were useful. Q2: The training program was helpful in improving my specialty performance. Q3: The training program was useful. Q4: The contents of the lectures were satisfactory. Q5: The lecturing methods were satisfactory. Q6: The difficulty level of the training program was appropriate. Q7: Training hours per day were appropriate. Q8: Communication in English or Khmer during the training program was smooth. Q9: The training program level was suitable for my capability. Q10: Overall, the training program was satisfactory. 3) Validity and Reliability Analysis of the Measurement Tool The results of the exploratory factor analysis conducted to verify the validity of the measurement tool are shown in Table 3 . The model fit results showed KMO = .760 and Bartlett’s χ² = 132.662 (p < .001), with 10 items grouped into 4 factors. The reliability analysis results for the measurement tool are shown in Table 4 . For all survey items in the measurement tool, Cronbach’s alpha values exceeded 0.7, indicating reliability. Table 3 Validity Analysis of the Measurement Tool Questions Factor 1 2 3 4 Q8 .880 .075 .042 .202 Q4 .878 .034 .186 .140 Q7 .579 .394 .091 .256 Q9 .565 .447 − .061 − .189 Q1 .066 .824 .051 − .075 Q2 .239 .698 .046 .469 Q5 .604 .608 .210 − .035 Q6 .091 − .094 .868 .055 Q3 .108 .399 .612 − .045 Q10 .159 − .022 .008 .903 Eigenvalue 2.67 2.07 1.22 1.21 Variance Explained (%) 26.72 20.67 12.25 12.08 Cumulative Variance Explained (%) 26.72 47.39 59.64 71.72 KMO = .760, Barlett's χ2 = 132.662(p < .001) Table 4 Reliability Analysis of the Measurement Tool Questions Cronbach's Alpha Q1 .785 Q2 .760 Q3 .787 Q4 .750 Q5 .750 Q6 .802 Q7 .753 Q8 .750 Q9 .773 Q10 .801 4) Differences in Learning Satisfaction Between in-person and synchronous virtually online Education A t-test was conducted to determine the differences in learning satisfaction between in-person education and synchronous virtually online education. The results are shown in Table 5 , demonstrating statistically significant differences in Q4 and Q10 between in-person and synchronous virtually online education (t = -0.190, p < 0.021). Considering the overall mean scores for all items, the mean score for learning satisfaction in in-person education was higher than in synchronous virtually online education; however, the difference was not statistically significant (t = 1.945,p = .061). Table 5 Comparison of Key Variables by Teaching Method Questions Group N M SD t p Q1 In-person 20 4.10 0.45 − .190 .850 synchronous virtually online 21 4.14 0.91 Q2 In-person 20 4.45 0.51 .980 .333 synchronous virtually online 21 4.29 0.56 Q3 In-person 20 4.45 0.51 .903 .372 synchronous virtually online 21 4.29 0.64 Q4 In-person 20 4.40 0.50 2.413 .021* synchronous virtually online 21 3.95 0.67 Q5 In-person 20 4.15 0.37 .054 .957 synchronous virtually online 21 4.14 0.48 Q6 In-person 20 3.90 0.55 − .028 .978 synchronous virtually online 21 3.90 0.54 Q7 In-person 20 4.25 0.55 1.551 .129 synchronous virtually online 21 3.95 0.67 Q8 In-person 20 4.35 0.59 2.019 .050 synchronous virtually online 21 3.95 0.67 Q9 In-person 20 4.15 0.81 .405 .688 synchronous virtually online 21 4.05 0.80 Q10 In-person 20 4.30 0.66 3.285** .002** synchronous virtually online 21 3.71 0.46 All Items In-person 20 42.50 2.31 1.945 .061 synchronous virtually online 21 40.38 4.40 *p < .05, **p < .01 5) Correlation Analysis of Factors Influencing Learning Satisfaction Pearson's correlation analysis was conducted to examine the relationships between each item and learning satisfaction. The results are shown in Table 6 , indicating that learning satisfaction was significantly positively correlated with all items: Q1 (r = .536, p < .001), Q2 (r = .673, p < .001), Q3 (r = .468, p < .01), Q4 (r = .730, p < .001), Q5 (r = .803, p < .001), Q6 (r = .313, p < .05), Q7 (r = .716, p < .001), Q8 (r = .727, p < .001), Q9 (r = .636, p < .001), and Q10 (r = .379, p < .05). Table 6 Correlation Analysis of Key Variables Variable Q1 Q 2 Q 3 Q 4 Q 5 Q 6 Q 7 Q 8 Q 9 Q 10 Learning Satisfaction Q1 1 Q2 .403** 1 Q3 .251 .282 1 Q4 .175 .329* .235 1 Q5 .520*** .531*** .388* .563*** 1 Q6 .032 .040 .197 .198 .174 1 Q7 .253 .562*** .175 .466** .514*** .178 1 Q8 .175 .342* .250 .789*** .554*** .042 .515*** 1 Q9 .329* .322* .136 .364* .549*** .081 .431** .354* 1 Q10 0.000 .295 0.000 .252 .094 .073 .190 .302 .049 1 Learning Satisfaction .536*** .673*** .468** .730*** .803*** .313* .716*** .727*** .636*** .379* 1 *p < .05, **p < .01, ***p < .001 6) Factors Influencing Learning Satisfaction Through Qualitative Analysis A content analysis was conducted based on participants’ written responses, yielding the following results: 6 − 1) In-person Education "I would like more practical sessions in the program." "I think this program is very useful for improving my job skills." "I believe the learning level is appropriate for me." "I am very grateful for the direct training provided to my colleagues." "I was satisfied because the training was conducted with Khmer interpretation, which improved my understanding and allowed me to ask questions freely." "It would be great to have annual in-person workshops." "The materials I learned will be useful for teaching my colleagues or students." 6 − 2) Synchronous virtually online Education "It was great to review the material with my colleagues through synchronous virtually online education." " synchronous virtually online learning greatly helped improve my knowledge." "I appreciated that the instructors repeatedly explained the theoretical content." 4. Discussion 1) Evaluation of Learning Satisfaction and Tool Validation This study compared and analyzed learning satisfaction with in-person and synchronous virtually online among Cambodian trainees participating in the rehabilitation program of the Dr. LEE Jong-wook Fellowship. It aimed to identify specific differences in effectiveness based on the teaching method and contribute to the development of rehabilitation health workforce training programs. Since the learning satisfaction evaluation tool used in this study was not validated for reliability and validity, the evaluation tool was verified. Validity verification ensures that the evaluation tool accurately reflects the concept of learning satisfaction it aims to measure, enabling it to objectively capture the trainees' experiences and satisfaction. Reliability verification evaluates whether consistent results can be obtained under the same conditions, ensuring the consistency and trustworthiness of the evaluation outcomes. 15) These processes enhanced the quality of the evaluation tool and established its suitability for use in similar health workforce training programs. Hence, the learning satisfaction evaluation outcomes can now be more meaningfully reflected in program improvements. 2) Variability in Trainee Perceptions and Implications for Curriculum Design In this study, the high standard deviation observed for Q1 (usefulness of instructors' lectures and advice) and Q9 (appropriateness of the training program) may stem from individual differences in the trainees' experiences. The mean score for Q1 was 4.12 (SD = 0.71), indicating that trainees found the instructors’ lectures and advice useful for their learning. This finding aligns with those of previous studies demonstrating the positive impact of teaching methods and instructor-student interaction on learning outcomes. 16)17) However, the relatively high standard deviation of 0.71 for Q1 suggests substantial individual differences in trainees’ perceptions of the usefulness of the lectures and advice. The mean score for Q9 was 4.09 (SD = 0.80), indicating that trainees positively evaluated the appropriateness of the training program. However, the higher standard deviation compared to Q1 suggests that the program's difficulty and structure may be perceived differently depending on the trainees' abilities and backgrounds. 18) These findings highlights the need to adjust teaching methods and curricula in future program designs to allow participants from diverse backgrounds to effectively learn. These findings highlight the need to adjust teaching methods and curricula in future program designs to accommodate learners with varying levels of education, professional experience, and cultural backgrounds more effectively. A potential approach could involve implementing a hybrid learning model, integrating in-person and synchronous virtually online components to maximize both interactive engagement and flexible access to learning materials. Additionally, context-specific educational interventions tailored to the professional roles and prior knowledge of trainees may enhance the overall effectiveness of the program. By adopting flexible and scalable training strategies—such as hybrid learning models, modular curriculum structures, and digital learning platforms—future programs can be better adapted for global healthcare workforce development, ensuring accessibility and sustainability across different regions and training environments 3) Differences in Satisfaction Between in-person education and Synchronous virtually online Education Significant differences in satisfaction between in-person and synchronous virtually online were observed in Q4 (satisfaction with lecture content) and Q10 (overall program satisfaction). These results showed that in-person education yielded higher satisfaction with the delivery of lecture content and overall program than synchronous virtually online education. This aligns with previous studies indicating that immediate interaction between instructors and trainees and non-verbal cues in in-person settings facilitate learning. 19)20) By contrast, synchronous virtually online may result in relatively lower engagement due to technological limitations affecting instruction quality. However, it offers flexible learning opportunities to trainees worldwide without physical distance constraints. 16)21) Therefore, future training programs should consider adopting a hybrid learning model that combines the strengths of both in-person and synchronous virtually online. Such a balanced learning model may better meet the satisfaction levels of trainees with diverse backgrounds and varying learning needs, such as differences in prior experience, professional roles, and required skill development in rehabilitation healthcare. 22) 4) Role of Communication and Language Accessibility Communication is critical in the education process for trainees. 23) Effective communication facilitates the clear delivery of learning content and helps learners understand and achieve their goals. Particularly, asking questions is a key learning element as it allows instructors to verify understanding, address unclear aspects, and enhance learning outcomes. In this study, learning satisfaction and communication showed a statistically significant and strong correlation (r = .727, p < .01). The use of Khmer language interpretation yielded positive results. Trainees demonstrated higher comprehension when taught in their native Khmer language compared to English and expressed greater satisfaction with interaction, as revealed through qualitative analysis. These positive outcomes can be attributed to the removal of language barriers, which increased engagement with the training content and facilitated smoother question-and-answer exchanges.. Especially in healthcare education involving complex concepts, native language interpretation is critical to maximize educational effectiveness. 24) However, it is necessary to ensure that trainees fully understand the content during the interpretation process. As interpretation may not always convey the original intent accurately, instructors need to make additional efforts to verify trainees' understanding after interpretation. As interpretation may not always convey the original intent accurately, instructors need to make additional efforts to verify trainees' understanding after interpretation, such as conducting follow-up discussions, asking comprehension-check questions, or using practical demonstrations. Furthermore, this study identified a limitation in the comprehension of medical terminology among Cambodian trainees compared to that in Korea. A healthcare education system in Cambodia was established during the French colonial era, and some hospitals and educational institutions continue to use French-style rehabilitation medicine terminology. 25) These differences in terminology caused difficulty in understanding certain concepts and posed challenges in fully conveying intended content during communication. Therefore, standardizing and providing training on medical terminology will be necessary to address these differences. This approach is expected to enable trainees to more accurately understand the training content, enhance communication efficiency, and maximize learning effectiveness. 5) Study Limitations and Future Research Directions There are several limitations to consider when interpreting and applying the findings of this study. First, no prior research has been conducted on learning satisfaction among trainees participating in the Cambodian rehabilitation clinical course of the Dr. LEE Jong-wook Fellowship Program, making direct comparisons with other research impossible. Second, the study results are based on a selective sample of Cambodian rehabilitation healthcare personnel, which limits the generalizability of the findings. Third, as this study is a cross-sectional study analyzing data from the 2023 final report, it cannot establish clear causal relationships between learning satisfaction and individual items. Fourth, the lack of longitudinal data prevents an assessment of how learning satisfaction evolves over time or how different educational interventions may impact long-term competency development. Conducting longitudinal follow-up studies would provide deeper insights into the sustained effects of in-person and synchronous virtually online, allowing for a more robust evaluation of program effectiveness. 6) Broader Implications for Healthcare Workforce Training Nonetheless, this study is significant as it systematically describes learning satisfaction with both in-perosn and synchronous virtually online education methods among all trainees participating in the 2023 Cambodian rehabilitation course of the Dr. LEE Jong-wook Fellowship Program. Particularly, in the unique context of developing Cambodia's healthcare workforce, quantifying learning satisfaction based on trainees' actual experiences and identifying specific needs through open-ended questions contributes to program improvements. Future research should conduct in-depth analyses of factors influencing learning satisfaction, providing a foundation for developing specific strategies to ensure the effective operation of healthcare workforce training programs in diverse environments. Furthermore, this study provides objective data on not only trainees' satisfaction but also the educational elements and improvements they require, offering critical foundational insights for structuring learning environments, educational content, and teaching methods in future healthcare workforce training programs. Beyond simply evaluating satisfaction, this study holds significance in presenting specific directions for educational programs that reflect the social, economic, and cultural characteristics of developing countries such as Cambodia. Conclusion This study analyzed the differences in effectiveness between in-person education and synchronous virtually online education by comparing learning satisfaction of trainees in Cambodia's rehabilitation health workforce training program. The results showed that in-person education yielded higher satisfaction in terms of interaction quality and support through immediate feedback. Synchronous virtually online education, In contrast, provided flexibility in time and location, making it a more suitable option for some learners. Additionally, conducting the training program in the Cambodian native language considerably enhanced trainees' satisfaction. By ensuring the reliability of the learning satisfaction evaluation tool through validity and reliability testing, the findings of this study can serve as foundational data for improving learning satisfaction in similar programs. The specific needs identified through open-ended questions can be incorporated into program design, thereby maximizing educational effectiveness. Future efforts should involve an in-depth analysis of the factors influencing learning satisfaction in healthcare workforce training programs in developing countries to create more effective and tailored educational environments. Declarations Acknowledgments Gratitude is extended to all participants who contributed data for this study. Author contributions Youmi Kim and Onyoo Kim planned and designed the study. Youmi Kim and Jin-su Heo performed statistical analyses, prepared tables, and interpreted the results. Onyoo Kim, Youmi Kim, Jin-su Heo, Hyejin Jung, and Jeongeun Lee wrote the manuscript. All authors read and approved the final manuscript. Funding This study was funded by the Korea Foundation for International Healthcare (KOFIH). (KOFIH-LJW-2024) Ethics approval and consent to participate This study was conducted after obtaining exemption approval from the Institutional Review Board of the National Rehabilitation Center (Approval No.: NRC-2024-04-024). Only participants who provided written consent after being informed of the study purpose and methods were included. The collected survey data were coded and electronic files were protected with passwords, while physical copies will be stored in a locked cabinet for three years. No adverse effects or risks arose from this study. Also, this study complies with the Declaration of Helsinki and relevant national ethical guidelines. Competing interests The authors report no competing interests. 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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-5593564","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":445080185,"identity":"80be594d-eb4e-4cd6-9775-f2c4c589be6e","order_by":0,"name":"Youmi Kim","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA8ElEQVRIiWNgGAWjYBACPhDxgIGBx769IRFIM/DwEdLCBiISGBjkDHgOPDYAaWEjVouxgUTiMwm4CF4t7D2GDxLbtiVuZ0hOq/yaYyfDxsD88NENfFp4zhgbJLbdTtzZcCzttuy2ZKDD2IyNc/BpkUhLkwBpaTjYk3ZbchszUAsPmzQBLek/wFoO838rltxWT4yW5GMMQC3GBscY0hg/bjtMhBaew4clEs7dlpPsYUiWZtx2nIeNmYBf+NkbGz98KLvNwy//IPHjz23V9vzszQ8f49MCBozQuGDmAZOElIPBH6jWH0SpHgWjYBSMgpEGANpGSL1VDtEzAAAAAElFTkSuQmCC","orcid":"","institution":"National Rehabilitation Center","correspondingAuthor":true,"prefix":"","firstName":"Youmi","middleName":"","lastName":"Kim","suffix":""},{"id":445080186,"identity":"c3a1c5c0-aaa6-4ca6-a160-72009542843b","order_by":1,"name":"Jin-su Heo","email":"","orcid":"","institution":"National Rehabilitation Center","correspondingAuthor":false,"prefix":"","firstName":"Jin-su","middleName":"","lastName":"Heo","suffix":""},{"id":445080187,"identity":"160ec6bd-cd8a-4afd-a1cd-303addbc6f4a","order_by":2,"name":"Hyejin Jung","email":"","orcid":"","institution":"Korea Foundation for International Healthcare","correspondingAuthor":false,"prefix":"","firstName":"Hyejin","middleName":"","lastName":"Jung","suffix":""},{"id":445080189,"identity":"41090188-045b-4e80-8487-74995b5351fa","order_by":3,"name":"Jeongeun Lee","email":"","orcid":"","institution":"Korea Foundation for International Healthcare","correspondingAuthor":false,"prefix":"","firstName":"Jeongeun","middleName":"","lastName":"Lee","suffix":""},{"id":445080191,"identity":"1cb5d334-cc0b-467a-a08f-b239b52af480","order_by":4,"name":"Onyoo Kim","email":"","orcid":"","institution":"National Rehabilitation Center","correspondingAuthor":false,"prefix":"","firstName":"Onyoo","middleName":"","lastName":"Kim","suffix":""}],"badges":[],"createdAt":"2024-12-06 12:08:14","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5593564/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5593564/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12909-025-08266-5","type":"published","date":"2025-12-02T15:57:44+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":97724550,"identity":"b082f407-e453-4b68-8812-bf3b1cd4967b","added_by":"auto","created_at":"2025-12-08 16:12:35","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1312982,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5593564/v1/6518cbd5-f697-4c8a-b3fd-dd1a471a9274.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Comparing the Effectiveness of in-person in country and synchronous virtually online for Cambodia’s Rehabilitation Health Workforce","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eWith the growing emphasis on workforce development and training in recipient countries for international development cooperation, the importance of invitation-based training in official development assistance (ODA) has been increasing. Furthermore, since the 2000s, the World Health Organization (WHO) has formulated strategies to strengthen and develop healthcare workforce capacity.\u003csup\u003e1)\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eAccording to the 2013 comprehensive evaluation of invitation-based training by the Korea Institute of Public Administration, a total of KRW(Korean Won) 239\u0026nbsp;billion was allocated from 2010 to 2012 for invitation-based training projects involving 22,527 trainees from 169 countries.\u003csup\u003e2)\u003c/sup\u003e The Korea International Cooperation Agency (KOICA), which accounts for approximately half of Korea's invitation training budget, spent KRW 3.9\u0026nbsp;billion for these programs.\u003csup\u003e3)\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eAs a public institution under the Ministry of Health and Welfare, the Korea Foundation for International Healthcare (KOFIH) has implemented various training programs tailored to partner countries' needs, focusing on the Dr. LEE Jong-wook Fellowship Program since 2007. The Dr. LEE Jong-wook Fellowship Program has hosted 1,500 trainees from 30 countries by 2024, with 161 trainees participating in 2023 alone and a budget of KRW 8.7\u0026nbsp;billion allocated for the year. Among these programs, the invitation-based training program for rehabilitation healthcare workforce development was first piloted in 2019 through collaboration between KOFIH and the Korea National Rehabilitation Center.\u003csup\u003e4)\u003c/sup\u003e From 2019 to 2024, a total of five sessions, including local training, were conducted, with 43 trainees completing the course. This program aims to train healthcare professionals from developing countries and contribute to strengthening their national healthcare services and healthcare systems by establishing networks and partnerships.\u003c/p\u003e\u003cp\u003eTo maximize the effectiveness of invitation-based training programs and strengthen healthcare workforce capacity, it is essential to analyze educational needs by surveying participants' perceptions and preferences and provide training programs focused on field-specific tasks and problem-solving.\u003csup\u003e5)\u003c/sup\u003e Particularly in healthcare education, where practical training based on theoretical knowledge is critical, in-eprson education has been emphasized.\u003csup\u003e6)\u003c/sup\u003e However, with the COVID-19 pandemic, a rapid shift from in-person to synchronous virtually online occurred, highlighting the global importance of online education. This shift has not involved merely a technical change but has considerably affected learners' satisfaction and educational effectiveness.\u003csup\u003e7)\u003c/sup\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eMany studies have explored the effectiveness of in-person and synchronous virtually online. synchronous virtually online offers advantages such as freedom from time and location constraints, and learners can control their learning environment and methods.\u003csup\u003e8)\u003c/sup\u003e However, it tends to be unidirectional, making it challenging to adjust the teaching pace or intensity based on learners' questions or reactions as in in-person settings.\u003csup\u003e9)\u003c/sup\u003e Additionally, interaction between instructors and learners decreases, whereas diverse activities outside of lessons rarely occur.\u003csup\u003e10)\u003c/sup\u003e By contrast, in-person education enables immediate feedback and hands-on learning.\u003csup\u003e11)\u003c/sup\u003e It also promotes social interaction among learners, enhancing their motivation and performance. However, the drawbacks of in-person education include time and location constraints and the difficulty of efficiently delivering educational content to large groups.\u003csup\u003e12)\u003c/sup\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eIn healthcare education, including rehabilitation, acquiring skills through practical experience is essential, which underscores the importance of in-person education while discussing the limitations of synchronous virtually online education. Nevertheless, the shift to synchronous virtually online education has become necessary, requiring research on differences in learning satisfaction due to this transition.\u003csup\u003e6)\u003c/sup\u003e Additionally, synchronous online sessions, which allow real-time interaction between instructors and learners, present both advantages and challenges. While they enable immediate feedback and maintain a structured learning pace, they may still lack the hands-on experience crucial for skill acquisition in rehabilitation training. Therefore, further analysis is needed to evaluate their effectiveness in comparison to in-perosn and asynchronous learning methods.\u003c/p\u003e\u003cp\u003eGiven this context, this study aimed to compare and analyze learning satisfaction between in-person and synchronous virtually online education among Cambodian trainees participating in the rehabilitation program of the Dr. LEE Jong-wook Fellowship. It sought to identify differences in effectiveness based on the mode of delivery and contribute to proposing future directions for rehabilitation health workforce training programs.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e"},{"header":"2. Methods","content":"\n\u003ch3\u003e1) Study Participants\u003c/h3\u003e\n\u003cp\u003eThe \"Dr. LEE Jong-wook Fellowship Clinical Program (Cambodian Rehabilitation)\" conducted by KOFIH was operated by the Korea National Rehabilitation Center under a commissioned contract. The analysis in this study is based on the 2023 program outcome report.\u003c/p\u003e \u003cp\u003e The study included 21 Cambodian rehabilitation healthcare professionals who participated in the 2023 Dr. LEE Jong-wook Fellowship Program. Participants were not randomly selected; instead, they were chosen based on specific inclusion criteria, including English proficiency, employment at a Cambodian national hospital, and their professional role as a doctor, nurse, or physical therapist. The exclusion criterion is rehabilitation healthcare personnel working in private hospitals rather than national hospitals. These criteria were established to ensure that trainees could effectively engage in the program and apply the acquired knowledge in their respective healthcare settings.\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eThe program was divided into in-person and synchronous virtually online education sessions. The synchronous virtually online education consisted of three sessions, each lasting three hours, totaling nine hours, whereas the in-person education comprised three sessions, each lasting four hours, totaling twelve hours. The training was divided into three categories: general education, specialized theory, and specialized practice. The general education included topics such as the history of rehabilitation in Korea, the Korean health insurance system, and Korean language education. The specialized theory and practice sessions were conducted by experts in each field, including physicians, nurses, and physical therapists.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\n\u003ch3\u003e2) Research Tools\u003c/h3\u003e\n\u003cp\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eThe survey was developed by modifying and supplementing the questionnaire designed in the \"Development of New Performance Indicators for the KOFIH Dr. LEE Jong-wook Fellowship Program\" study\u003csup\u003e13)\u003c/sup\u003e to align with the purpose of this research.\u003c/p\u003e\u003cp\u003eThe questionnaire comprised 15 items, including 4 items on general characteristics, 10 multiple-choice items on learning satisfaction, and 1 open-ended item on learning satisfaction. The general characteristics section surveyed gender, affiliated institution, job type, and career experience. The multiple-choice items on learning satisfaction assessed the usefulness of learning, its applicability to work, learning methods, media selection, learning level, and satisfaction with communication. The questionnaire used a five-point Likert scale (strongly disagree, disagree, neutral, agree, strongly agree) and was scored from 0 to 50, with higher scores indicating higher learning satisfaction. The open-ended question on learning satisfaction allowed participants to describe in their own words their satisfaction or dissatisfaction with the training. The survey was conducted after explaining its content to the participants and obtaining their consent. Participants who engaged in in-person education completed the survey in person using a self-administered format, whereas those in synchronous virtually online training completed the survey via Google Forms. The survey was conducted immediately after the final session of each type of training (IRB-NRC-2024-04-024).\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\n\u003ch3\u003e3) Statistical Methods\u003c/h3\u003e\n\u003cp\u003e \u003cdiv class=\"BlockQuote\"\u003e \u003cp\u003eData collected in the study were analyzed using the IBM SPSS Statistics 27. Frequency analysis was used to determine the general characteristics of the participants, whereas descriptive statistics were employed to analyze the mean and standard deviation of the main variables measured. To verify the suitability of the questionnaire items, validity and reliability analyses were conducted, and differences in learning satisfaction between the in-person educaiton and synchronous virtually online groups were analyzed using an independent t-test. Pearson's correlation analysis was performed to examine the relationship between the main variables and learning satisfaction. Additionally, factors influencing learning satisfaction were interpreted using content analysis, one of the qualitative research methods, based on responses to the open-ended question. The content analysis was conducted based on the participants' written responses to the open-ended question.\u003csup\u003e4)14)\u003c/sup\u003e\u003c/p\u003e \u003c/div\u003e \u003c/p\u003e"},{"header":"3. Results","content":"\n\u003ch3\u003e1) General Characteristics of Participants\u003c/h3\u003e\n\u003cp\u003e \u003cdiv class=\"BlockQuote\"\u003e \u003cp\u003eThe general characteristics of the participants are shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. Male participants accounted for 60%, participants affiliated with the Khmer-Soviet Friendship Hospital for 80%, physical therapists for 65%, and participants with at least 10 years of experience for 55% of the total.\u003c/p\u003e \u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePersonal characteristics of participants (N\u0026thinsp;=\u0026thinsp;21)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristic\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12(57)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9(43)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eAffiliation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKhmer-Soviet Friendship Hospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17(80)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBattambang Hospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2(10)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNational Pediatric Hospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1(5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1(5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eOccupation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePhysician\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3(14)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNurse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5(25)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePhysical Therapist\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13(61)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCareer Experience\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLess than 10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10(47)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10 years or more\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11(53)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\n\u003ch3\u003e2) Descriptive Statistics for Main Variables\u003c/h3\u003e\n\u003cp\u003e \u003cdiv class=\"BlockQuote\"\u003e \u003cp\u003eDescriptive statistics for the main variables are shown in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. The highest average scores were for Q2 (mean 4.36, SD\u0026thinsp;=\u0026thinsp;0.54) and Q3 (mean 4.36, SD\u0026thinsp;=\u0026thinsp;0.58), whereas the lowest score was for Q10 (mean 4.00, SD\u0026thinsp;=\u0026thinsp;0.63). The highest standard deviation was for Q9 (mean 4.09, SD\u0026thinsp;=\u0026thinsp;0.80), and the lowest standard deviation was for Q5 (mean 4.14, SD\u0026thinsp;=\u0026thinsp;0.42).\u003c/p\u003e \u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDescriptive Statistics for Main Variables\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQuestions\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMinimum\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMaximum\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSD values\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.71\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.54\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.58\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.63\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.42\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.54\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.62\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.65\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.80\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.63\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eQ1: My professor's teaching and advice related to my specialty were useful.\u003c/p\u003e \u003cp\u003eQ2: The training program was helpful in improving my specialty performance.\u003c/p\u003e \u003cp\u003eQ3: The training program was useful.\u003c/p\u003e \u003cp\u003eQ4: The contents of the lectures were satisfactory.\u003c/p\u003e \u003cp\u003eQ5: The lecturing methods were satisfactory.\u003c/p\u003e \u003cp\u003eQ6: The difficulty level of the training program was appropriate.\u003c/p\u003e \u003cp\u003eQ7: Training hours per day were appropriate.\u003c/p\u003e \u003cp\u003eQ8: Communication in English or Khmer during the training program was smooth.\u003c/p\u003e \u003cp\u003eQ9: The training program level was suitable for my capability.\u003c/p\u003e \u003cp\u003eQ10: Overall, the training program was satisfactory.\u003c/p\u003e\n\u003ch3\u003e3) Validity and Reliability Analysis of the Measurement Tool\u003c/h3\u003e\n\u003cp\u003e \u003cdiv class=\"BlockQuote\"\u003e \u003cp\u003eThe results of the exploratory factor analysis conducted to verify the validity of the measurement tool are shown in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e. The model fit results showed KMO\u0026thinsp;=\u0026thinsp;.760 and Bartlett\u0026rsquo;s χ\u0026sup2; = 132.662 (p\u0026thinsp;\u0026lt;\u0026thinsp;.001), with 10 items grouped into 4 factors.\u003c/p\u003e \u003cp\u003eThe reliability analysis results for the measurement tool are shown in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e. For all survey items in the measurement tool, Cronbach\u0026rsquo;s alpha values exceeded 0.7, indicating reliability.\u003c/p\u003e \u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eValidity Analysis of the Measurement Tool\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eQuestions\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c5\" namest=\"c2\"\u003e \u003cp\u003eFactor\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.880\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.075\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.042\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.202\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.878\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.034\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.186\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.140\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.579\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.394\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.091\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.256\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.565\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.447\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.061\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.189\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.066\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.824\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.051\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.075\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.239\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.698\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.046\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.469\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.604\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.608\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.210\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.035\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.091\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.094\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.868\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.055\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.108\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.399\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.612\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.045\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.159\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.022\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.008\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.903\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEigenvalue\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.21\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariance Explained (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e26.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12.08\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCumulative Variance Explained (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e26.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e47.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e59.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e71.72\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eKMO\u0026thinsp;=\u0026thinsp;.760, Barlett's χ2\u0026thinsp;=\u0026thinsp;132.662(p\u0026thinsp;\u0026lt;\u0026thinsp;.001)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eReliability Analysis of the Measurement Tool\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQuestions\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCronbach's Alpha\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.785\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.760\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.787\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.750\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.750\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.802\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.753\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.750\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.773\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.801\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\n\u003ch3\u003e4) Differences in Learning Satisfaction Between in-person and synchronous virtually online Education\u003c/h3\u003e\n\u003cp\u003e \u003cdiv class=\"BlockQuote\"\u003e \u003cp\u003eA t-test was conducted to determine the differences in learning satisfaction between in-person education and synchronous virtually online education. The results are shown in Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e, demonstrating statistically significant differences in Q4 and Q10 between in-person and synchronous virtually online education (t = -0.190, p\u0026thinsp;\u0026lt;\u0026thinsp;0.021). Considering the overall mean scores for all items, the mean score for learning satisfaction in in-person education was higher than in synchronous virtually online education; however, the difference was not statistically significant (t\u0026thinsp;=\u0026thinsp;1.945,p\u0026thinsp;=\u0026thinsp;.061).\u003c/p\u003e \u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of Key Variables by Teaching Method\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQuestions\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGroup\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eM\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003et\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003ep\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eQ1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eIn-person\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.190\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e.850\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003esynchronous virtually online\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.91\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eQ2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eIn-person\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e.980\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e.333\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003esynchronous virtually online\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.56\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eQ3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eIn-person\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e.903\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e.372\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003esynchronous virtually online\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.64\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eQ4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eIn-person\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e2.413\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e.021*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003esynchronous virtually online\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.67\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eQ5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eIn-person\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e.054\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e.957\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003esynchronous virtually online\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.48\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eQ6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eIn-person\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.028\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e.978\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003esynchronous virtually online\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.54\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eQ7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eIn-person\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1.551\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e.129\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003esynchronous virtually online\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.67\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eQ8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eIn-person\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e2.019\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e.050\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003esynchronous virtually online\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.67\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eQ9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eIn-person\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e.405\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e.688\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003esynchronous virtually online\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.80\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eQ10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eIn-person\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e3.285**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e.002**\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003esynchronous virtually online\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.46\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eAll\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eItems\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eIn-person\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e42.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1.945\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e.061\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003esynchronous virtually online\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e40.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.40\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003e*p\u0026thinsp;\u0026lt;\u0026thinsp;.05, **p\u0026thinsp;\u0026lt;\u0026thinsp;.01\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\n\u003ch3\u003e5) Correlation Analysis of Factors Influencing Learning Satisfaction\u003c/h3\u003e\n\u003cp\u003ePearson's correlation analysis was conducted to examine the relationships between each item and learning satisfaction. The results are shown in Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e, indicating that learning satisfaction was significantly positively correlated with all items: Q1 (r\u0026thinsp;=\u0026thinsp;.536, p\u0026thinsp;\u0026lt;\u0026thinsp;.001), Q2 (r\u0026thinsp;=\u0026thinsp;.673, p\u0026thinsp;\u0026lt;\u0026thinsp;.001), Q3 (r\u0026thinsp;=\u0026thinsp;.468, p\u0026thinsp;\u0026lt;\u0026thinsp;.01), Q4 (r\u0026thinsp;=\u0026thinsp;.730, p\u0026thinsp;\u0026lt;\u0026thinsp;.001), Q5 (r\u0026thinsp;=\u0026thinsp;.803, p\u0026thinsp;\u0026lt;\u0026thinsp;.001), Q6 (r\u0026thinsp;=\u0026thinsp;.313, p\u0026thinsp;\u0026lt;\u0026thinsp;.05), Q7 (r\u0026thinsp;=\u0026thinsp;.716, p\u0026thinsp;\u0026lt;\u0026thinsp;.001), Q8 (r\u0026thinsp;=\u0026thinsp;.727, p\u0026thinsp;\u0026lt;\u0026thinsp;.001), Q9 (r\u0026thinsp;=\u0026thinsp;.636, p\u0026thinsp;\u0026lt;\u0026thinsp;.001), and Q10 (r\u0026thinsp;=\u0026thinsp;.379, p\u0026thinsp;\u0026lt;\u0026thinsp;.05).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCorrelation Analysis of Key Variables\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"12\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eQ1\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eQ 2\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eQ 3\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eQ 4\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eQ 5\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQ 6\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eQ 7\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eQ 8\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eQ 9\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cp\u003eQ 10\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c12\"\u003e \u003cp\u003eLearning\u003c/p\u003e \u003cp\u003eSatisfaction\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.403**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.251\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.282\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.175\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.329*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.235\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.520***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.531***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.388*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.563***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.032\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.040\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.197\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.198\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.174\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.253\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.562***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.175\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.466**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.514***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.178\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.175\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.342*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.250\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.789***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.554***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.042\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.515***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.329*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.322*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.136\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.364*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.549***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.081\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.431**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.354*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.295\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.252\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.094\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.073\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.190\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.302\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.049\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLearning\u003c/p\u003e \u003cp\u003eSatisfaction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.536***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.673***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.468**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.730***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.803***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.313*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.716***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.727***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.636***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e.379*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"12\"\u003e*p\u0026thinsp;\u0026lt;\u0026thinsp;.05, **p\u0026thinsp;\u0026lt;\u0026thinsp;.01, ***p\u0026thinsp;\u0026lt;\u0026thinsp;.001\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\n\u003ch3\u003e6) Factors Influencing Learning Satisfaction Through Qualitative Analysis\u003c/h3\u003e\n\u003cp\u003eA content analysis was conducted based on participants\u0026rsquo; written responses, yielding the following results:\u003c/p\u003e\n\u003ch3\u003e6 − 1) In-person Education\u003c/h3\u003e\n\u003cp\u003e \u003cem\u003e\"I would like more practical sessions in the program.\"\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e\"I think this program is very useful for improving my job skills.\"\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e\"I believe the learning level is appropriate for me.\"\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e\"I am very grateful for the direct training provided to my colleagues.\"\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e\"I was satisfied because the training was conducted with Khmer interpretation, which improved my understanding and allowed me to ask questions freely.\"\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e\"It would be great to have annual in-person workshops.\"\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e\"The materials I learned will be useful for teaching my colleagues or students.\"\u003c/em\u003e \u003c/p\u003e\n\u003ch3\u003e6 − 2) Synchronous virtually online Education\u003c/h3\u003e\n\u003cp\u003e \u003cem\u003e\"It was great to review the material with my colleagues through synchronous virtually online education.\"\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e\" synchronous virtually online learning greatly helped improve my knowledge.\"\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e\"I appreciated that the instructors repeatedly explained the theoretical content.\"\u003c/em\u003e \u003c/p\u003e"},{"header":"4. Discussion","content":"\n\u003ch3\u003e1) Evaluation of Learning Satisfaction and Tool Validation\u003c/h3\u003e\n\u003cp\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e This study compared and analyzed learning satisfaction with in-person and synchronous virtually online among Cambodian trainees participating in the rehabilitation program of the Dr. LEE Jong-wook Fellowship. It aimed to identify specific differences in effectiveness based on the teaching method and contribute to the development of rehabilitation health workforce training programs. Since the learning satisfaction evaluation tool used in this study was not validated for reliability and validity, the evaluation tool was verified. Validity verification ensures that the evaluation tool accurately reflects the concept of learning satisfaction it aims to measure, enabling it to objectively capture the trainees' experiences and satisfaction. Reliability verification evaluates whether consistent results can be obtained under the same conditions, ensuring the consistency and trustworthiness of the evaluation outcomes.\u003csup\u003e15)\u003c/sup\u003e These processes enhanced the quality of the evaluation tool and established its suitability for use in similar health workforce training programs. Hence, the learning satisfaction evaluation outcomes can now be more meaningfully reflected in program improvements.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\n\u003ch3\u003e2) Variability in Trainee Perceptions and Implications for Curriculum Design\u003c/h3\u003e\n\u003cp\u003e \u003cdiv class=\"BlockQuote\"\u003e \u003cp\u003eIn this study, the high standard deviation observed for Q1 (usefulness of instructors' lectures and advice) and Q9 (appropriateness of the training program) may stem from individual differences in the trainees' experiences. The mean score for Q1 was 4.12 (SD\u0026thinsp;=\u0026thinsp;0.71), indicating that trainees found the instructors\u0026rsquo; lectures and advice useful for their learning. This finding aligns with those of previous studies demonstrating the positive impact of teaching methods and instructor-student interaction on learning outcomes.\u003csup\u003e16)17)\u003c/sup\u003e However, the relatively high standard deviation of 0.71 for Q1 suggests substantial individual differences in trainees\u0026rsquo; perceptions of the usefulness of the lectures and advice. The mean score for Q9 was 4.09 (SD\u0026thinsp;=\u0026thinsp;0.80), indicating that trainees positively evaluated the appropriateness of the training program. However, the higher standard deviation compared to Q1 suggests that the program's difficulty and structure may be perceived differently depending on the trainees' abilities and backgrounds.\u003csup\u003e18)\u003c/sup\u003e These findings highlights the need to adjust teaching methods and curricula in future program designs to allow participants from diverse backgrounds to effectively learn. These findings highlight the need to adjust teaching methods and curricula in future program designs to accommodate learners with varying levels of education, professional experience, and cultural backgrounds more effectively. A potential approach could involve implementing a hybrid learning model, integrating in-person and synchronous virtually online components to maximize both interactive engagement and flexible access to learning materials. Additionally, context-specific educational interventions tailored to the professional roles and prior knowledge of trainees may enhance the overall effectiveness of the program. By adopting flexible and scalable training strategies\u0026mdash;such as hybrid learning models, modular curriculum structures, and digital learning platforms\u0026mdash;future programs can be better adapted for global healthcare workforce development, ensuring accessibility and sustainability across different regions and training environments\u003c/p\u003e \u003c/div\u003e \u003c/p\u003e\n\u003ch3\u003e3) Differences in Satisfaction Between in-person education and Synchronous virtually online Education\u003c/h3\u003e\n\u003cp\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eSignificant differences in satisfaction between in-person and synchronous virtually online were observed in Q4 (satisfaction with lecture content) and Q10 (overall program satisfaction). These results showed that in-person education yielded higher satisfaction with the delivery of lecture content and overall program than synchronous virtually online education. This aligns with previous studies indicating that immediate interaction between instructors and trainees and non-verbal cues in in-person settings facilitate learning.\u003csup\u003e19)20)\u003c/sup\u003e By contrast, synchronous virtually online may result in relatively lower engagement due to technological limitations affecting instruction quality. However, it offers flexible learning opportunities to trainees worldwide without physical distance constraints.\u003csup\u003e16)21)\u003c/sup\u003e Therefore, future training programs should consider adopting a hybrid learning model that combines the strengths of both in-person and synchronous virtually online. Such a balanced learning model may better meet the satisfaction levels of trainees with diverse backgrounds and varying learning needs, such as differences in prior experience, professional roles, and required skill development in rehabilitation healthcare.\u003csup\u003e22)\u003c/sup\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\n\u003ch3\u003e4) Role of Communication and Language Accessibility\u003c/h3\u003e\n\u003cp\u003e \u003cdiv class=\"BlockQuote\"\u003e \u003cp\u003eCommunication is critical in the education process for trainees.\u003csup\u003e23)\u003c/sup\u003e Effective communication facilitates the clear delivery of learning content and helps learners understand and achieve their goals. Particularly, asking questions is a key learning element as it allows instructors to verify understanding, address unclear aspects, and enhance learning outcomes. In this study, learning satisfaction and communication showed a statistically significant and strong correlation (r\u0026thinsp;=\u0026thinsp;.727, p\u0026thinsp;\u0026lt;\u0026thinsp;.01). The use of Khmer language interpretation yielded positive results. Trainees demonstrated higher comprehension when taught in their native Khmer language compared to English and expressed greater satisfaction with interaction, as revealed through qualitative analysis. These positive outcomes can be attributed to the removal of language barriers, which increased engagement with the training content and facilitated smoother question-and-answer exchanges.. Especially in healthcare education involving complex concepts, native language interpretation is critical to maximize educational effectiveness.\u003csup\u003e24)\u003c/sup\u003e However, it is necessary to ensure that trainees fully understand the content during the interpretation process. As interpretation may not always convey the original intent accurately, instructors need to make additional efforts to verify trainees' understanding after interpretation. As interpretation may not always convey the original intent accurately, instructors need to make additional efforts to verify trainees' understanding after interpretation, such as conducting follow-up discussions, asking comprehension-check questions, or using practical demonstrations. Furthermore, this study identified a limitation in the comprehension of medical terminology among Cambodian trainees compared to that in Korea. A healthcare education system in Cambodia was established during the French colonial era, and some hospitals and educational institutions continue to use French-style rehabilitation medicine terminology.\u003csup\u003e25)\u003c/sup\u003e These differences in terminology caused difficulty in understanding certain concepts and posed challenges in fully conveying intended content during communication. Therefore, standardizing and providing training on medical terminology will be necessary to address these differences. This approach is expected to enable trainees to more accurately understand the training content, enhance communication efficiency, and maximize learning effectiveness.\u003c/p\u003e \u003c/div\u003e \u003c/p\u003e\n\u003ch3\u003e5) Study Limitations and Future Research Directions\u003c/h3\u003e\n\u003cp\u003e \u003cdiv class=\"BlockQuote\"\u003e \u003cp\u003eThere are several limitations to consider when interpreting and applying the findings of this study. First, no prior research has been conducted on learning satisfaction among trainees participating in the Cambodian rehabilitation clinical course of the Dr. LEE Jong-wook Fellowship Program, making direct comparisons with other research impossible. Second, the study results are based on a selective sample of Cambodian rehabilitation healthcare personnel, which limits the generalizability of the findings. Third, as this study is a cross-sectional study analyzing data from the 2023 final report, it cannot establish clear causal relationships between learning satisfaction and individual items. Fourth, the lack of longitudinal data prevents an assessment of how learning satisfaction evolves over time or how different educational interventions may impact long-term competency development. Conducting longitudinal follow-up studies would provide deeper insights into the sustained effects of in-person and synchronous virtually online, allowing for a more robust evaluation of program effectiveness.\u003c/p\u003e \u003c/div\u003e \u003c/p\u003e\n\u003ch3\u003e6) Broader Implications for Healthcare Workforce Training\u003c/h3\u003e\n\u003cp\u003e \u003cdiv class=\"BlockQuote\"\u003e \u003cp\u003eNonetheless, this study is significant as it systematically describes learning satisfaction with both in-perosn and synchronous virtually online education methods among all trainees participating in the 2023 Cambodian rehabilitation course of the Dr. LEE Jong-wook Fellowship Program. Particularly, in the unique context of developing Cambodia's healthcare workforce, quantifying learning satisfaction based on trainees' actual experiences and identifying specific needs through open-ended questions contributes to program improvements. Future research should conduct in-depth analyses of factors influencing learning satisfaction, providing a foundation for developing specific strategies to ensure the effective operation of healthcare workforce training programs in diverse environments.\u003c/p\u003e \u003cp\u003eFurthermore, this study provides objective data on not only trainees' satisfaction but also the educational elements and improvements they require, offering critical foundational insights for structuring learning environments, educational content, and teaching methods in future healthcare workforce training programs. Beyond simply evaluating satisfaction, this study holds significance in presenting specific directions for educational programs that reflect the social, economic, and cultural characteristics of developing countries such as Cambodia.\u003c/p\u003e \u003c/div\u003e \u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003e \u003cdiv class=\"BlockQuote\"\u003e \u003cp\u003eThis study analyzed the differences in effectiveness between in-person education and synchronous virtually online education by comparing learning satisfaction of trainees in Cambodia's rehabilitation health workforce training program. The results showed that in-person education yielded higher satisfaction in terms of interaction quality and support through immediate feedback. Synchronous virtually online education, In contrast, provided flexibility in time and location, making it a more suitable option for some learners. Additionally, conducting the training program in the Cambodian native language considerably enhanced trainees' satisfaction.\u003c/p\u003e \u003cp\u003eBy ensuring the reliability of the learning satisfaction evaluation tool through validity and reliability testing, the findings of this study can serve as foundational data for improving learning satisfaction in similar programs. The specific needs identified through open-ended questions can be incorporated into program design, thereby maximizing educational effectiveness.\u003c/p\u003e \u003cp\u003eFuture efforts should involve an in-depth analysis of the factors influencing learning satisfaction in healthcare workforce training programs in developing countries to create more effective and tailored educational environments.\u003c/p\u003e \u003c/div\u003e \u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eGratitude is extended to all participants who contributed data for this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eYoumi Kim and Onyoo Kim planned and designed the study. Youmi Kim and Jin-su Heo performed statistical analyses, prepared tables, and interpreted the results. Onyoo Kim, Youmi Kim, Jin-su Heo, Hyejin Jung, and Jeongeun Lee wrote the manuscript. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was funded by the Korea Foundation for International Healthcare (KOFIH). (KOFIH-LJW-2024)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was conducted after obtaining exemption approval from the Institutional Review Board of the National Rehabilitation Center (Approval No.: NRC-2024-04-024). Only participants who provided written consent after being informed of the study purpose and methods were included. The collected survey data were coded and electronic files were protected with passwords, while physical copies will be stored in a locked cabinet for three years. No adverse effects or risks arose from this study. Also, this study complies with the Declaration of Helsinki and relevant national ethical guidelines.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors report no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability statements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and analysed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical Trial Number\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eWorld Health Organization. The world health report 2006: working together for health. World Health Organization; 2006.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHong JH, Choi SY, Park SC, Oh YK. Integrated evaluation of invitational training project. Seoul: Korea Institute of Public Administration; 2013.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKorea International Cooperation Agency Web Site. (2003) [Internet]. Seongnam: Korea International Cooperation Agency [cited 2023 Jun 7]. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://www.koica.go.kr/\u003c/span\u003e\u003cspan address=\"http://www.koica.go.kr/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKim Y, Kim W, Kim E, Jung H, Kim S, Kim O. A qualitative study on satisfaction with healthcare workforce training programs: Focusing on the clinical course of the Dr. LEE Jong-wook Fellowship Program (Cambodia Rehabilitation). Health Policy Manage. 2023;33(2):157\u0026ndash;65.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChauhan R, Ghosh P, Rai A, Shukla D. The impact of supportive work environment on employee training transfer: A study of government employees in India. Int J Train Dev. 2016;20(3):200\u0026ndash;13.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHong S, Yoo Y. Analysis of factors influencing learning outcomes in remote education environments due to COVID-19. J Educational Technol. 2020;36(Special):957\u0026ndash;89.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKwon OH. A study on the learning satisfaction and learning immersion of blended learning (face-to-face) classes between Korean and foreign college students after covid-19 -To H University in Seoul Department of Beauty Design Management. J Korean Soc Cosmetology. 2021;27(4):1053\u0026ndash;61.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYang MS. The image and teaching of online educators effects of learning immersion on Learning Satisfaction - For Students Majoring in Beauty. Hansung University: Department of Beauty Art \u0026amp; Design Graduate School of Arts; 2021.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHong SY, Ryu YJ. Factors affecting college students\u0026rsquo; learning outcomes in non face-to-face evironment during Covid-19 pandemic. J Educational Technol. 2020;36(3):957\u0026ndash;89.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNguyen T. The effectiveness of online learning: Beyond no significant difference and future horizons. MERLOT J Online Learn Teach. 2015;11(2):309\u0026ndash;19.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLee Y, Shin D. An investigation of the implementation of online classes in the untact era caused by the COVID-19 pandemic. J Curriculum Evaluation. 2020;23(4):39\u0026ndash;57.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGarc\u0026iacute;a-Mart\u0026iacute;n J, Garc\u0026iacute;a-S\u0026aacute;nchez J-N. (2021). Active participation and interaction, key performance factors of face-to-face higher education. \u003cem\u003eEducation Sciences\u003c/em\u003e, 11(12), 820.Eun, S. G., Park, Y. S., \u0026amp; Ko, D. W. (2014). Characteristic analysis of lotting-out and fee system in resort management contract-focusing on interview with an expert. International Journal of Tourism Management and Science, 29(5), 117\u0026ndash;137.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHattie J. Visible learning: A synthesis of over 800 meta-analyses relating to achievement. London: Routledge; 2008.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLee S, Choi K, Yoon J. Student perception of instructional methods and its influence on educational outcomes. Educational Evaluation J. 2021;10(4):122\u0026ndash;37.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFreeman S, Eddy SL, McDonough M, Smith MK, Okoroafor N, Jordt H, Wenderoth MP. (2014). Active learning increases student performance in science, engineering, and mathematics. Proceedings of the National Academy of Sciences, 111(23), 8410\u0026ndash;8415.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYoon J, Lee H, Kim M. Variability in program effectiveness: A comparison of instructional strategies. Int J Program Evaluation. 2020;8(3):45\u0026ndash;60.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRazinkina E, Pankova L, Trostinskaya I, Pozdeeva E, Evseeva L, Tanova A. (2018). Student satisfaction as an element of education quality monitoring in innovative higher education institution. E3S Web of Conferences, 33, 03043. EDP Sciences.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChoi H, Kim E, Park S. Interactive teaching and learning in face-to-face vs. online education. Educational Res Reviews. 2021;16(5):12\u0026ndash;28.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChen Y. The impact of online learning on student engagement. J Educational Technol. 2019;12(3):75\u0026ndash;88.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGinzburg T. Student perception of face-to-face vs. online language training: The case of adult learners in Latvia. Int J Smart Educ Urban Soc (IJSEUS). 2022;13(1):1\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eArrosagaray M, Gonz\u0026aacute;lez-Peiteado M, Pino-Juste M, Rodr\u0026iacute;guez-L\u0026oacute;pez B. A comparative study of Spanish adult students\u0026rsquo; attitudes to ICT in classroom, blended and distance language learning modes. Comput Educ. 2019;134:31\u0026ndash;40.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWorld Physiotherapy. (2023). [Internet}. Cambodian Physical Therapy Association. World Physiotherapy [cited 2024.09.03]. Available from: https://world.physio.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGallego Ortega JL, Rodr\u0026iacute;guez Fuentes A. Communication skills training in trainee primary school teachers in Spain. Int Electron J Elementary Educ. 2015;8(1):85\u0026ndash;98. ​.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKim S. A study on Korean medical interpretation: Focusing on medical tourism interpretation and multicultural medical interpretation. J Translation Stud. 2018;19(2):7\u0026ndash;37.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHealth Care in Cambodia. (1990). \u003cem\u003eCultural Survival Quarterly Magazine\u003c/em\u003e. Retrieved from \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.culturalsurvival.org/publications/cultural-survival-quarterly/health-care-cambodia\u003c/span\u003e\u003cspan address=\"https://www.culturalsurvival.org/publications/cultural-survival-quarterly/health-care-cambodia\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"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":"Cambodian trainees, Dr. LEE Jong-wook Fellowship, Health workforce training, In-person in country, Rehabilitation, Synchronous virtually online","lastPublishedDoi":"10.21203/rs.3.rs-5593564/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5593564/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eThe study aimed to analyze the differences in learning satisfaction between in-person in country and synchronous virtually online among Cambodian trainees in the Dr. LEE Jong-wook Fellowship Program. Given the necessity to strengthen health workforce capacity in developing countries, this study provides insights into the effectiveness of training delivery modes to improve rehabilitation healthcare personnel training.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA quantitative study was conducted to evaluate learning satisfaction, incorporating both structured survey responses and anecdotal comments from open-ended questions. The study employed a validated learning satisfaction tool, adjusted for reliability and validity. In the synchronous virtually online training sessions, an online survey using a 5-point Likert scale was conducted, while in the in-person in-country training sessions, data were collected through direct surveys. Study participants were selected using convenience sampling.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eMale participants comprised 60% of the total, while 80% were affiliated with the Khmer-Soviet Friendship Hospital. Additionally, 65% were physical therapists, and 55% had at least 10 years of experience. The findings indicated higher satisfaction in in-person in country, attributed to increased interaction and real-time feedback(Q4: t\u0026thinsp;=\u0026thinsp;2.413, p\u0026thinsp;=\u0026thinsp;0.021; Q10: t\u0026thinsp;=\u0026thinsp;3.285, p\u0026thinsp;=\u0026thinsp;0.002). However, synchronous virtually online was preferred by trainees for its flexibility. Additionally, conducting the program in the Cambodian native language considerably enhanced trainee satisfaction.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eThis study highlights the strengths and limitations of different educational delivery methods in healthcare workforce training. It suggests that a hybrid approach, incorporating both in-person in country and synchronous virtually online in trainees' native language, may optimize learning satisfaction and engagement in future programs.\u003c/p\u003e","manuscriptTitle":"Comparing the Effectiveness of in-person in country and synchronous virtually online for Cambodia’s Rehabilitation Health Workforce","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-04-21 13:09:48","doi":"10.21203/rs.3.rs-5593564/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-04-30T08:23:37+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-04-29T13:51:54+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-04-25T23:28:12+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-04-25T19:17:48+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-04-24T16:06:01+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"291796150502784035237055795478160671371","date":"2025-04-24T14:44:33+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"156171538840573679918372326397616631284","date":"2025-04-24T07:47:52+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"28587143169835527191576529590418988379","date":"2025-04-21T02:03:19+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"195567045858729842740575787726555027562","date":"2025-04-21T01:30:43+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"110206664810821402735456019422974900933","date":"2025-04-21T01:10:15+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-04-19T08:48:37+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"194880380143365745683412426979764794721","date":"2025-04-19T08:40:29+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-04-18T17:30:14+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-04-12T13:12:50+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Medical Education","date":"2025-04-07T14:53:52+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":"78d1e9ac-847d-4c9c-bfa9-2002539f6082","owner":[],"postedDate":"April 21st, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-12-08T16:08:45+00:00","versionOfRecord":{"articleIdentity":"rs-5593564","link":"https://doi.org/10.1186/s12909-025-08266-5","journal":{"identity":"bmc-medical-education","isVorOnly":false,"title":"BMC Medical Education"},"publishedOn":"2025-12-02 15:57:44","publishedOnDateReadable":"December 2nd, 2025"},"versionCreatedAt":"2025-04-21 13:09:48","video":"","vorDoi":"10.1186/s12909-025-08266-5","vorDoiUrl":"https://doi.org/10.1186/s12909-025-08266-5","workflowStages":[]},"version":"v1","identity":"rs-5593564","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5593564","identity":"rs-5593564","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}