Transforming Educator Expectations in Public Health, Nursing, and Medicine: A Two-Phase Survey on Digital Tools in Education

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Schaal, Maria A. Marchwacka, Daniel Tolks, Joachim Kugler This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6706933/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 08 Dec, 2025 Read the published version in BMC Medical Education → Version 1 posted 12 You are reading this latest preprint version Abstract The present research project utilized cross-sectional surveys administered to faculty members from the fields of medical sciences, public health and nursing. The objective of the present study was to explore perceptions, experiences and future intentions regarding digital teaching methodologies. It is evident that digital platforms such as Zoom, Moodle and MS Teams have become widely utilized tools, primarily for the dissemination of content as opposed to facilitating interactive engagement. The faculty acknowledged the advantages of enhanced accessibility and heightened institutional attractiveness. However, the study also identified substantial challenges, including a considerable time investment, inadequate institutional support, and uncertainty regarding the efficacy of digital methods on learning outcomes. The results of the study demonstrate the importance of strategic institutional reforms, targeted didactic training, and clear policies that recognize the contribution of digital teaching to the sustainable enhancement of educational practices in healthcare disciplines. digital transformation digital teaching higher education Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Introduction The digital transformation of higher education in healthcare has undergone a marked acceleration, predominantly driven by the emergency response necessitated by the COVD-19 pandemic (Jeffries et al. 2022, Kumar et al. 2021). Conventionally, healthcare education has relied predominantly on face-to-face, practice-oriented teaching methodologies, emphasizing clinical skills, patient interaction, and experiential learning (Fontaine et al., 2017; Hew & Lo, 2018; van Alten et al. 2019, Kononowicz et al. 2019, Cheng 2019). However, prior to the advent of the pandemic, the adoption of digital methodologies in pedagogical practice remained in its infancy. As demonstrated in the German research by Winde et al. (2020) and Gilch et al. (2019), the number of courses offered digitally prior to the advent of the pandemic was minimal, with a mere 12% of courses being delivered digitally. Furthermore, only 14% of German higher education institutions had a defined digitization strategy in place (Winde et al. 2020; Gilch et al. 2019). The sudden shift to emergency remote teaching has necessitated a rapid adaptation of pedagogical approaches by universities and faculties. This transition has brought to light both significant potential and existing gaps in these approaches. This transition presented significant challenges, particularly in light of the deeply entrenched culture of physical presence in healthcare education. The pressing nature of the situation precipitated the swift implementation of a variety of digital teaching methodologies. The specific approaches adopted were contingent on a number of factors, including the availability of resources, the digital competencies of faculty members, infrastructure, and the constrained timeframe (Strelan et al. 2020, Dost 2022). Whilst a full evaluation of these digital semesters is still pending, preliminary assessments have indicated that lecturers, universities and students have expressed a general level of satisfaction with the developments. It is noteworthy that 75% of lecturers reported positive experiences with digital teaching, despite 49% of these having conducted digital teaching for the first time (Winde et al., 2020). A recent systematic review on online learning presents a heterogeneous picture: A survey of relevant studies revealed that 36% concluded online learning to be effective, 52% indicated negative outcomes, and 12% reported neutral findings (Meng et al., 2024). It is important to note that studies which employ higher methodological standards (e.g. randomized controlled trials) have consistently demonstrated positive learning outcomes. Conversely, studies which assess student satisfaction have predominantly reported negative perceptions. In Germany, a number of pilot projects have successfully explored the implementation of digital teaching methods within person-centered curricula. These include communication training, simulation-based patient interactions, and online examinations (Tolks et al., 2021; Schaal et al., 2022). The results of the study indicate that the digital transformation in academic institutions has been only partially realised, due to a number of impediments. The aforementioned issues comprise inadequate communication, insufficient coordination, and unclear roles and responsibilities. Consequently, a marked demand has been observed for more precise definitions and practical guidelines concerning digital strategies. These insights underscore the pressing need for comprehensive pedagogical reforms in healthcare higher education, with a particular emphasis on the systematic integration of digital competencies and innovative teaching methodologies. The present study thus examines faculty members' perceptions and evaluations of the shift towards digital teaching in health care, nursing and medicine, identifies preferred digital tools, and derives critical implications for future pedagogical strategies in healthcare education. Methods Two independent, advertising-free, cross-sectional surveys were conducted via www.soscisurvey.de for scientific purposes. The first survey occurred from June to August 2020 and the second from June to July 2021. The online survey was designed by the Teaching Section of the German Public Health Association (DGPH) and the Digitization Committee of the Society for Medical Education (GMA), with participation from the Education and Counseling Section of the German Nursing Association (DGP) and the Teaching Working Group of the German Society for Medical Sociology (DGMS). This collaboration allowed for the inclusion of university and college faculty from the disciplines of public health/health sciences, health education, medicine and nursing (Marchwacka et al. 2022). Participation was voluntary and the sample was a convenience sample without a predetermined size calculation. The questionnaire allowed questions to remain unanswered to avoid a high dropout rate from forced responses. Missing values were not replaced. Approximately 1,700 members of the aforementioned organizations received access to the survey via a web link within their respective society's newsletter. Personalized participation links were not utilized due to data protection regulations regarding member data. Participants were informed of the objectives, voluntary participation, and anonymous data processing, and were required to give their consent to data protection before proceeding. A comprehensive data protection concept was available for download. The survey adhered to the guidelines for ensuring good scientific practice (DFG 2019). The convenience sample of the initial survey comprised 100 university teachers (i.e. professors, research assistants and lecturers). The second survey included 138 university teachers. The participants in the two surveys could not be linked. The data were prepared and analyzed using SPSS (version 27). The survey's objective was to describe and assess digital teaching from the perspective of faculty who redesigned face-to-face teaching due to the COVID-19 pandemic in the first and third digital semesters, and to descriptively identify change trends. The standardized survey, with predominantly closed questions, collected data on the use and application of digital technologies in teaching, tools for digital teaching, digital teaching-learning concepts, faculty experiences and attitudes, challenges in digital teaching, and evaluation concepts and data protection. The survey was modeled on the Bertelsmann Stiftung's 2017 "Monitor Digitale Bildung" (Müller-Eiselt 2017, Schmid et al. 2017). Both online surveys were functionally and linguistically checked and adapted in a pretest. The second online survey was supplemented with content relating to future digital orientation in the “New Normal-Teaching”. Results In the first survey, 100 and in the second survey 138 teachers from the health sector took part, most of whom teach in the fields of medicine (53 and 59 % respectively), public health/health sciences (28 and 34 % respectively) and nursing (24 and 18 % respectively) (Table 1). The questionnaire was answered by 60 women, 38 men and 2 diverse persons in the first survey and by 88 women and 50 men in the second survey. In terms of status groups, 47 or 50% of the participants were academic staff, followed by professors (32 or 27.5%) and teachers (13 or 13.8%). Most participants have more than 10 years of professional experience (Table 2). 29% and 31.2% of the participants had 11-20 years of teaching experience and 26% and 28% had more than 20 years of experience. Table 1: Courses Courses Frequency (absolute) 1st survey 2nd survey Public Health/Health Sciences 28 48 Health Education 10 12 Medicine 53 82 Nursing 24 26 Teacher Education 14 11 Table 2: Experience as a lecturer/ teacher Courses Frequency (absolute) 1st survey 2nd survey Public Health/Health Sciences 28 48 Health Education 10 12 Medicine 53 82 Nursing 24 26 Teacher Education 14 11 The most commonly used digital platforms in the analysis (Figure 1) were Zoom, Moodle and MS Teams. <> The utilization of digital media by faculty members was predominantly focused on content dissemination rather than on interactive digital or collaborative educational activities, such as audience response systems, simulations, learning apps (Figure 2). <> A six-point scale was utilized to ascertain how university teachers encapsulate their understanding and practical experience concerning the utilization of digital technologies in educational contexts (Figure 3). The outcomes of this investigation suggest a notable consensus among the surveyed participants that the employment of digital teaching methodologies is often characterized by a substantial investment of time. Furthermore, positive perceptions were noted for improving accessibility for physically challenged learners, enhancing motivation, and increasing institutional attractiveness. In contrast, the assertion that digital teaching and learning provisions contribute to a reduction in the rate of attrition received the least consensus. Respondents expressed comparatively lower levels of agreement with regard to the capacity of digital education to enhance learning outcomes or to effectively monitor student success. Moreover, concerns were raised regarding the capacity of digital formats to alleviate the workload of instructors or to enhance access for students from disadvantaged socio-economic backgrounds. The divergence of opinion was evident in responses to statements proposing that digital teaching methods impede individual learning and contribute to elevated rates of attrition within academic programs. These results underscore the faculty's nuanced perspectives, demonstrating a simultaneous recognition of digital education's benefits and awareness of its persistent limitations and challenges. <> The following results were obtained in relation to the satisfaction of digitally mediated teaching: The survey results indicated that respondents expressed the highest levels of satisfaction with their own digital skills (Figure 4). This finding was particularly noted in the second survey and suggests an improvement or adaptation over time. Satisfaction with teaching from home offices and the implementation of digitally supported teaching methods also received relatively high rankings, reflecting adaptation to remote educational environments. Conversely, faculty members reported moderate satisfaction regarding communication with students, collegial exchange, and didactic support from universities, indicating potential areas requiring further improvement. Student performance and skills acquisition received only average ratings, thus highlighting ongoing concerns about digital formats effectively supporting student learning outcomes. The comparative nature of the results indicates slight improvements from the first to the second survey across most categories, which may be indicative of enhanced faculty familiarity and adaptability to digital teaching methods. However, the ongoing moderate satisfaction levels in critical domains such as didactic support and student outcomes underscore the necessity for targeted institutional interventions and professional development initiatives. <> The following expectations have been formulated concerning the future utilization of various digital teaching and learning forms and was only collected in the second survey (Figure 5): Education videos and learning management systems (e.g., Moodle, Ilias) received the highest affirmative responses, indicating strong faculty acceptance and anticipated continued use. Digital collaboration methods (e.g., whiteboards, media projects) and inverted classroom approaches were viewed positively by faculty members, albeit with a degree of uncertainty. The utilization of self-learning programs, incorporating simulation applications, has elicited a range of responses from faculty members, indicative of a prevailing ambivalence or unfamiliarity with such educational methodologies. The response systems demonstrated the highest degree of uncertainty, thus emphasizing the presence of a substantial undecided faculty group, despite the acknowledged potential for enhancing student engagement. One interesting aspect noted was the willingness to continue digital teaching of health professions at universities - even after the Pandemic period: 44 participants said they would use digital teaching in the future, while 30 said they would not. <> Discussion The results of the study indicate that Zoom, Moodle and MS Teams are the most widely used digital platforms in higher education teaching of health sciences/nursing or medical sciences. However, this use is largely driven by institutional and technical requirements rather than explicit didactic decisions by lecturers. In particular, the positive tendency to continue digital practices such as educational videos and learning management systems indicates their established acceptance and perceived effectiveness for university educators. Nevertheless, the use of digital formats has been predominantly for content delivery, with comparatively less emphasis on interactive or collaborative learning activities, including audience response systems, learning apps and simulation-based applications. These, therefore, have yet to reach their full potential. The reason for this could be a lack of didactic innovation (Tolks et al., 2016 , Kwon et al. 2021 , Marchwacka et al. 2022 ). Regarding the continued use of digital teaching methods in the post-pandemic era, a mixed response was observed among teaching professionals. While just over half of respondents expressed a positive view, a significant proportion expressed skepticism or reluctance. With regard to the question: ‘If you summarize your knowledge and experience with digital learning - how do you rate digital learning?’, the statements digital teaching and learning opportunities improve access for physically impaired learners and promote the attractiveness of the university were rated more negatively in the second survey than in the first; all other statements received more approval. Furthermore, despite the obvious benefits, a strong perception of digital teaching as time-consuming, coupled with unclear institutional recognition and support mechanisms, emerges as a significant barrier. These perceptions point to the critical need for structural reforms in institutional policy, in particular the clarification and recognition of digital teaching efforts in workload calculations and the provision of robust didactic and technical support (Müller et al., 2018 ; Benning et al., 2020 , Tudor et al. 2021). University educators have reservations about the effectiveness of digital teaching methods in reducing attrition rates and enhancing personalized learning experiences (Gilch et al., 2019 , Schaal et al. 2022 , Hempel et al. 2022 ). This skepticism highlights the need for additional research that is clearly and firmly grounded in empirical evidence, and that focuses specifically on the efficacy of digital teaching methodologies. And research to explore the underlying motivational factors and barriers to the use of innovative digital methods and tools (Marchwacka et al. 2022 , Jeffries et al. 2022 , Bond et al. 2020 ). With the increasing use of AI technologies in health sciences education, there is also a growing need to further develop the digital skills of faculty (Meng et al., 2024, Burr et a. 2024). As a result, institutions will be compelled to integrate ethical and legal dimensions more intensively into continuing education programmes, in addition to technical aspects. Recommendations In order to advance digital higher education in healthcare, it is essential that institutions priorities targeted faculty training in interactive digital tools and methodologies. In order to facilitate the sustainable and successful integration of digital teaching methods, it is imperative that specific didactic qualifications, digital competence and institutional frameworks are in place (Joint Research Centre 2022). Moreover, the implementation of systematic evaluation strategies is imperative to assess the long-term impacts of digital teaching on student learning outcomes. The exploration and integration of emerging technologies, such as artificial intelligence, has the potential to significantly enhance educational effectiveness in healthcare professions. Declarations Ethics approval and consent to participate All subjects gave their informed consent for inclusion before they participated in the study. The study was conducted in accordance with the Declaration of Helsinki. The online survey was conducted among members of the Teaching Section of the German Society for Public Health (DGPH), the Digitization Committee of the Society for Medical Education (GMA), the Education and Counseling Section of the German Nursing Association (DGP), and the Teaching Working Group of the German Society for Medical Sociology (DGMS). The invitation to participate and initial information about the survey were included in the regular newsletters of the aforementioned societies. All participants in this study were informed about the purpose, form, and scope of the collection and processing. Prior to participation, participants had to clearly agree to the data protection information on the landing page of the online survey (informed consent). Otherwise, participant was redirected to the end of the questionnaire and excluded from the survey. Participation was voluntary, opting out was possible at any time, and the survey was anonymous. An ethics vote is not required according to §13 of the German Data Protection Regulation (DSGVO) in conjunction with the "Guidelines for Online Surveys" of the Association of German Market and Social Research Institutes. Participants were asked to evaluate the teaching and learning conditions during the COVID-19 pandemic. The survey was conducted in line with the Bertelsmann Foundation's "Monitor Digital Education" from 2017. The monitor covers the various forms of digital learning in schools, vocational training, higher education and continuing education. The survey does not include patient or disease data or information on the health status of respondents. Studies of the human body were not conducted. As a result of the study, conclusions are drawn as to how teaching at universities can be better designed in the future. Consent for publication Not applicable Availability of data and materials All data generated or analyzed during this study are included in the supplementary information files. Competing interests The authors declare that they have no competing interests. Funding Not applicable Authors' contributions All authors contributed in writing the manuscript. TS was programming the Online-Survey and did descriptive statistics. JK and DT developed the questionnaire. MW did statistical analysis and proofread of the manuscript. TS, MW, DT and JK approved the final version of the manuscript. Acknowledgements We thank all participants for their participation and realization of the study. References Burr P, Kumar A, Young T. The potential of AI text-to-image generation in medical education: the educator and students' perspective. In: Beckingham S, Lawrence J, Powell S, Hartley P, editors. Using Generative AI Effectively in Higher Education. Milton Park, UK. Routledge; 2024. Benning NH, Haag M, Knaup P, Krefting D, Rienhoff O, Suhr M, u. a. Digital teaching as an instrument for cross-location teaching networks in medical informatics: opportunities and challenges. GMS J Med Educ. 16. November 2020;37(6):Doc56. Bond M, Buntins K, Bedenlier S, Zawacki-Richter O, Kerres M. Mapping research in student engagement and educational technology in higher education: a systematic evidence map. In: International Journal of Educational Technology in Higher Education 17 (2020) 1, S. 1-30 Cheng L, Ritzhaupt AD, Antonenko P. Effects of the flipped classroom instructional strategy on students’ learning outcomes: a meta-analysis. Education Tech Research Dev. 2019;67:793–824. DFG. Leitlinien zur Sicherung guter wissenschaftlicher Praxis. Bonn: Deutsche Forschungsgemeinschaft; 2019 Dost S, Hossain A, Shehab M, Abdelwahed A, Al-Nusair L. Perceptions of medical students towards online teaching during the COVID-19 pandemic: a national cross-sectional survey of 2721 UK medical students. BMJ Open 2020;10:e042378. https://doi.org/10.1136/bmjopen-2020-042378 Fontaine G, Cossette S, Maheu-Cadotte MA, Mailhot T, Deschênes MF, Mathieu-Dupuis G. Effectiveness of Adaptive E-Learning Environments on Knowledge, Competence, and Behavior in Health Professionals and Students: Protocol for a Systematic Review and Meta-Analysis. JMIR Res Protoc. 2017;6:e128. Gilch H, Beise AS, Krempkow R, Müller M, Stratmann F, Wannemacher K. Digitalisierung der Hochschulen. Ergebnisse einer Schwerpunktstudie für die Expertenkommission Forschung und Innovation. Berlin: HIS-Institut für Hochschulentwicklung; 2019. Hempel G, Weissenbacher A, Stehr SN. [COVID-19: a chance for digitalization of teaching? : Report of experiences and results of a survey on digitalized teaching in the fields of anesthesiology, intensive care, emergency, pain and palliative medicine at the University of Leipzig]. Anaesthesist. 2022;71:340–9. Hew KF, Lo CK. Flipped classroom improves student learning in health professions education: a meta-analysis. BMC Medical Education. 2018;18:38. Jeffries P R, Bushardt R L, DuBose-Morris R, Hood C, Kardong-Edgren S, Pintz C, Posey L & Sikka N. The role of technology in health professions education during the COVID-19 pandemic. Academic Medicine, 2022;97(3), S104–S109. https://doi.org/10.1097/ACM.0000000000004523 Joint Research Centre, J. C.R.: DigComp 2.2 - the Digital Competence Framework for Citizens. With new examples of knowledge, skills and attitudes. Luxembourg 2022. URL: https://op.europa.eu/en/publication-detail/-/publication/50c53c01-abeb-11ec-83e1-01aa75ed71a1/language-en/format-PDF/source-280137285 Kononowicz AA, Woodham LA, Edelbring S, Stathakarou N, Davies D, Saxena N, et al. Virtual Patient Simulations in Health Professions Education: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration. J Med Internet Res. 2019;21:e14676. Kwon S, Kim W, Bae C, Cho M, Lee S, Dreamson N. The identity changes in online learning and teaching: instructors, learners, and learning management systems. Int J Educ Technol High Educ. 2021;18(1):67. Kumar A, Sarkar M, Davis E, Morphet J, Maloney S, Ilic D, & Palermo C. Impact of the COVID-19 pandemic on teaching and learning in health professional education: A mixed methods study protocol. BMC Medical Education, 2021;21(1), 439. https://doi.org/10.1186/s12909-021-02871-w Marchwacka, M.A., Kugler, J., Schaal, T., Tolks, D. (2022): Digitale Hochschullehre im ersten COVID-19-Semester. Ergebnisse einer Untersuchung in Public Health, Medizin und Pflege. In: Präv Gesundheitsf 18 , 22–29 (2023). https://doi.org/10.1007/s11553-022-00937-1. Meng W, Lei Y, Liu C, Pan N, Pang X, & Zhu Y. A systematic review of the effectiveness of online learning in higher education during the COVID-19 pandemic period. 2024;Frontiers in Education, 8. Müller C, Füngerlings S, Tolks D. Teaching load – a barrier to digitalisation in higher education? A position paper on the framework surrounding higher education medical teaching in the digital age using Bavaria, Germany as an example. GMS J Med Educ. 2018;35(3):Doc34. Müller-Eiselt R (2017) Materialsammlung Monitor Digitale Bildung. https://www.bertelsmann-stiftung.de/de/unsere-projekte/teilhabe-in-einer-digitalisierten-welt/monitor/materialsammlung-monitor-digitale-bildung. Accessed: May 4, 2025 Schaal T, Marchwacka MA, Tolks D, Kugler J. Change and adoption of digital learning formats during the COVID-19 pandemic. A trend study from Germany. IJLTET. SPECIAL ISSUE - ICTIMESH – 2022: 101-106. Schmid U, Goertz L, Radomski S, Thom S, Behrens J. Monitor Digitale Bildung. Die Hochschulen im digitalen Zeitalter. Gütersloh: Bertelsmann Stiftung; 2017. Strelan P, Osborn A, Palmer E. The flipped classroom: A meta-analysis of effects on student performance across disciplines and education levels. Educational Research Review. 2020;30. Tolks D, Schäfer C, Raupach T, Kruse L, Sarikas A, Gerhardt-Szép S, et al. An Introduction to the Inverted/Flipped Classroom Model in Education and Advanced Training in Medicine and in the Healthcare Professions. GMS J Med Educ. 2016;33:Doc46. Tudor Car L, Kyaw BM, Nannan Panday RS, van der Kleij R, Chavannes N, Majeed A, Car J Digital Health Training Programs for Medical Students: Scoping Review JMIR Med Educ 2021;7(3):e28275 doi: 10.2196/28275 van Alten DCD, Phielix C, Janssen J, Kester L Effects of flipping the classroom on learning outcomes and satisfaction: A meta-analysis. Educational Research Review. 2019;28. Winde M, Werner S, Gumbmann B, Hieronimus S. Hochschulen, Corona und jetzt? Essen: Stifterverband; 2020. Additional Declarations No competing interests reported. Supplementary Files OverallDataset.csv OverallDataset.sav Cite Share Download PDF Status: Published Journal Publication published 08 Dec, 2025 Read the published version in BMC Medical Education → Version 1 posted Editorial decision: Revision requested 05 Sep, 2025 Reviews received at journal 04 Sep, 2025 Reviewers agreed at journal 21 Aug, 2025 Reviews received at journal 28 Jul, 2025 Reviewers agreed at journal 23 Jul, 2025 Reviews received at journal 16 Jul, 2025 Reviewers agreed at journal 13 Jul, 2025 Reviewers invited by journal 02 Jul, 2025 Editor assigned by journal 24 Jun, 2025 Editor invited by journal 30 May, 2025 Submission checks completed at journal 29 May, 2025 First submitted to journal 29 May, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6706933","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":480074410,"identity":"cb9fd0e2-b807-4b39-b93c-8f2566d321ca","order_by":0,"name":"Tom K. 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16:14:57","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1518578,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6706933/v1/f82da9f2-c860-4242-bd90-62ddaa962838.pdf"},{"id":86035088,"identity":"e6a4685a-4afa-4448-ab66-0b2368df5073","added_by":"auto","created_at":"2025-07-04 15:23:02","extension":"csv","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":216702,"visible":true,"origin":"","legend":"","description":"","filename":"OverallDataset.csv","url":"https://assets-eu.researchsquare.com/files/rs-6706933/v1/2cf111912f2dcdb555e06835.csv"},{"id":86035094,"identity":"453984db-29de-41d8-ba25-3b6bfdbf360e","added_by":"auto","created_at":"2025-07-04 15:23:02","extension":"sav","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":426088,"visible":true,"origin":"","legend":"","description":"","filename":"OverallDataset.sav","url":"https://assets-eu.researchsquare.com/files/rs-6706933/v1/34a68df4a8dc6dcf5b2753eb.sav"}],"financialInterests":"No competing interests reported.","formattedTitle":"Transforming Educator Expectations in Public Health, Nursing, and Medicine: A Two-Phase Survey on Digital Tools in Education","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe digital transformation of higher education in healthcare has undergone a marked acceleration, predominantly driven by the emergency response necessitated by the COVD-19 pandemic (Jeffries et al. 2022, Kumar et al. 2021). Conventionally, healthcare education has relied predominantly on face-to-face, practice-oriented teaching methodologies, emphasizing clinical skills, patient interaction, and experiential learning (Fontaine et al., 2017; Hew \u0026amp; Lo, 2018; van Alten et al. 2019, Kononowicz et al. 2019, Cheng 2019).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eHowever, prior to the advent of the pandemic, the adoption of digital methodologies in pedagogical practice remained in its infancy. As demonstrated in the German research by Winde et al. (2020) and Gilch et al. (2019), the number of courses offered digitally prior to the advent of the pandemic was minimal, with a mere 12% of courses being delivered digitally. Furthermore, only 14% of German higher education institutions had a defined digitization strategy in place (Winde et al. 2020; Gilch et al. 2019). The sudden shift to emergency remote teaching has necessitated a rapid adaptation of pedagogical approaches by universities and faculties. This transition has brought to light both significant potential and existing gaps in these approaches. This transition presented significant challenges, particularly in light of the deeply entrenched culture of physical presence in healthcare education. The pressing nature of the situation precipitated the swift implementation of a variety of digital teaching methodologies. The specific approaches adopted were contingent on a number of factors, including the availability of resources, the digital competencies of faculty members, infrastructure, and the constrained timeframe (Strelan et al. 2020, Dost 2022).\u003c/p\u003e\n\u003cp\u003eWhilst a full evaluation of these digital semesters is still pending, preliminary assessments have indicated that lecturers, universities and students have expressed a general level of satisfaction with the developments. It is noteworthy that 75% of lecturers reported positive experiences with digital teaching, despite 49% of these having conducted digital teaching for the first time (Winde et al., 2020). A recent systematic review on online learning presents a heterogeneous picture: A survey of relevant studies revealed that 36% concluded online learning to be effective, 52% indicated negative outcomes, and 12% reported neutral findings (Meng et al., 2024). It is important to note that studies which employ higher methodological standards (e.g. randomized controlled trials) have consistently demonstrated positive learning outcomes. Conversely, studies which assess student satisfaction have predominantly reported negative perceptions.\u003c/p\u003e\n\u003cp\u003eIn Germany, a number of pilot projects have successfully explored the implementation of digital teaching methods within person-centered curricula. These include communication training, simulation-based patient interactions, and online examinations (Tolks et al., 2021; Schaal et al., 2022). The results of the study indicate that the digital transformation in academic institutions has been only partially realised, due to a number of impediments. The aforementioned issues comprise inadequate communication, insufficient coordination, and unclear roles and responsibilities. Consequently, a marked demand has been observed for more precise definitions and practical guidelines concerning digital strategies.\u003c/p\u003e\n\u003cp\u003eThese insights underscore the pressing need for comprehensive pedagogical reforms in healthcare higher education, with a particular emphasis on the systematic integration of digital competencies and innovative teaching methodologies. The present study thus examines faculty members' perceptions and evaluations of the shift towards digital teaching in health care, nursing and medicine, identifies preferred digital tools, and derives critical implications for future pedagogical strategies in healthcare education.\u003c/p\u003e"},{"header":"Methods ","content":"\u003cp\u003eTwo independent, advertising-free, cross-sectional surveys were conducted via www.soscisurvey.de for scientific purposes. The first survey occurred from June to August 2020 and the second from June to July 2021. The online survey was designed by the Teaching Section of the German Public Health Association (DGPH) and the Digitization Committee of the Society for Medical Education (GMA), with participation from the Education and Counseling Section of the German Nursing Association (DGP) and the Teaching Working Group of the German Society for Medical Sociology (DGMS). This collaboration allowed for the inclusion of university and college faculty from the disciplines of public health/health sciences, health education, medicine and nursing (Marchwacka et al. 2022).\u003c/p\u003e\n\u003cp\u003eParticipation was voluntary and the sample was a convenience sample without a predetermined size calculation. The questionnaire allowed questions to remain unanswered to avoid a high dropout rate from forced responses. Missing values were not replaced. Approximately 1,700 members of the aforementioned organizations received access to the survey via a web link within their respective society's newsletter. Personalized participation links were not utilized due to data protection regulations regarding member data. Participants were informed of the objectives, voluntary participation, and anonymous data processing, and were required to give their consent to data protection before proceeding. A comprehensive data protection concept was available for download. The survey adhered to the guidelines for ensuring good scientific practice (DFG 2019). The convenience sample of the initial survey comprised 100 university teachers (i.e. professors, research assistants and lecturers). The second survey included 138 university teachers. The participants in the two surveys could not be linked. The data were prepared and analyzed using SPSS (version 27).\u003c/p\u003e\n\u003cp\u003eThe survey's objective was to describe and assess digital teaching from the perspective of faculty who redesigned face-to-face teaching due to the COVID-19 pandemic in the first and third digital semesters, and to descriptively identify change trends. The standardized survey, with predominantly closed questions, collected data on the use and application of digital technologies in teaching, tools for digital teaching, digital teaching-learning concepts, faculty experiences and attitudes, challenges in digital teaching, and evaluation concepts and data protection. The survey was modeled on the Bertelsmann Stiftung's 2017 \"Monitor Digitale Bildung\" (Müller-Eiselt 2017, Schmid et al. 2017). Both online surveys were functionally and linguistically checked and adapted in a pretest. The second online survey was supplemented with content relating to future digital orientation in the “New Normal-Teaching”.\u0026nbsp;\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eIn the first survey, 100 and in the second survey 138 teachers from the health sector took part, most of whom teach in the fields of medicine (53 and 59 % respectively), public health/health sciences (28 and 34 % respectively) and nursing (24 and 18 % respectively) (Table 1). The questionnaire was answered by 60 women, 38 men and 2 diverse persons in the first survey and by 88 women and 50 men in the second survey. In terms of status groups, 47 or 50% of the participants were academic staff, followed by professors (32 or 27.5%) and teachers (13 or 13.8%). Most participants have more than 10 years of professional experience (Table 2). 29% and 31.2% of the participants had 11-20 years of teaching experience and 26% and 28% had more than 20 years of experience.\u003c/p\u003e\n\u003cp\u003eTable 1: Courses\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCourses\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency (absolute)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e\u003cem\u003e1st survey\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e\u003cem\u003e2nd survey\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003ePublic Health/Health Sciences\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003eHealth Education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003eMedicine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e82\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003eNursing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003eTeacher Education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;Table 2: Experience as a lecturer/ teacher\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCourses\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency (absolute)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e\u003cem\u003e1st survey\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e\u003cem\u003e2nd survey\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003ePublic Health/Health Sciences\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003eHealth Education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003eMedicine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e82\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003eNursing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003eTeacher Education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;The most commonly used digital platforms in the analysis (Figure 1) were Zoom, Moodle and MS Teams.\u003c/p\u003e\n\u003cp\u003e\u0026lt;\u0026lt;insert FIGURE 1\u0026gt;\u0026gt;\u003c/p\u003e\n\u003cp\u003eThe utilization of digital media by faculty members was predominantly focused on content dissemination rather than on interactive digital or collaborative educational activities, such as audience response systems, simulations, learning apps (Figure 2).\u003c/p\u003e\n\u003cp\u003e\u0026lt;\u0026lt;insert FIGURE 2\u0026gt;\u0026gt;\u003c/p\u003e\n\u003cp\u003eA six-point scale was utilized to ascertain how university teachers encapsulate their understanding and practical experience concerning the utilization of digital technologies in educational contexts (Figure 3). The outcomes of this investigation suggest a notable consensus among the surveyed participants that the employment of digital teaching methodologies is often characterized by a substantial investment of time. Furthermore, positive perceptions were noted for improving accessibility for physically challenged learners, enhancing motivation, and increasing institutional attractiveness. In contrast, the assertion that digital teaching and learning provisions contribute to a reduction in the rate of attrition received the least consensus. Respondents expressed comparatively lower levels of agreement with regard to the capacity of digital education to enhance learning outcomes or to effectively monitor student success. Moreover, concerns were raised regarding the capacity of digital formats to alleviate the workload of instructors or to enhance access for students from disadvantaged socio-economic backgrounds. The divergence of opinion was evident in responses to statements proposing that digital teaching methods impede individual learning and contribute to elevated rates of attrition within academic programs. These results underscore the faculty\u0026apos;s nuanced perspectives, demonstrating a simultaneous recognition of digital education\u0026apos;s benefits and awareness of its persistent limitations and challenges.\u003c/p\u003e\n\u003cp\u003e\u0026lt;\u0026lt;insert FIGURE 3\u0026gt;\u0026gt;\u003c/p\u003e\n\u003cp\u003eThe following results were obtained in relation to the satisfaction of digitally mediated teaching:\u003c/p\u003e\n\u003cp\u003eThe survey results indicated that respondents expressed the highest levels of satisfaction with their own digital skills (Figure 4). This finding was particularly noted in the second survey and suggests an improvement or adaptation over time. Satisfaction with teaching from home offices and the implementation of digitally supported teaching methods also received relatively high rankings, reflecting adaptation to remote educational environments. Conversely, faculty members reported moderate satisfaction regarding communication with students, collegial exchange, and didactic support from universities, indicating potential areas requiring further improvement. Student performance and skills acquisition received only average ratings, thus highlighting ongoing concerns about digital formats effectively supporting student learning outcomes.\u003c/p\u003e\n\u003cp\u003eThe comparative nature of the results indicates slight improvements from the first to the second survey across most categories, which may be indicative of enhanced faculty familiarity and adaptability to digital teaching methods. However, the ongoing moderate satisfaction levels in critical domains such as didactic support and student outcomes underscore the necessity for targeted institutional interventions and professional development initiatives.\u003c/p\u003e\n\u003cp\u003e\u0026lt;\u0026lt;insert FIGURE 4\u0026gt;\u0026gt;\u003c/p\u003e\n\u003cp\u003eThe following expectations have been formulated concerning the future utilization of various digital teaching and learning forms and was only collected in the second survey (Figure 5): Education videos and learning management systems (e.g., Moodle, Ilias) received the highest affirmative responses, indicating strong faculty acceptance and anticipated continued use. Digital collaboration methods (e.g., whiteboards, media projects) and inverted classroom approaches were viewed positively by faculty members, albeit with a degree of uncertainty. The utilization of self-learning programs, incorporating simulation applications, has elicited a range of responses from faculty members, indicative of a prevailing ambivalence or unfamiliarity with such educational methodologies. The response systems demonstrated the highest degree of uncertainty, thus emphasizing the presence of a substantial undecided faculty group, despite the acknowledged potential for enhancing student engagement.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOne interesting aspect noted was the willingness to continue digital teaching of health professions at universities - even after the Pandemic period: 44 participants said they would use digital teaching in the future, while 30 said they would not.\u003c/p\u003e\n\u003cp\u003e\u0026lt;\u0026lt;insert FIGURE 5\u0026gt;\u0026gt;\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe results of the study indicate that Zoom, Moodle and MS Teams are the most widely used digital platforms in higher education teaching of health sciences/nursing or medical sciences. However, this use is largely driven by institutional and technical requirements rather than explicit didactic decisions by lecturers. In particular, the positive tendency to continue digital practices such as educational videos and learning management systems indicates their established acceptance and perceived effectiveness for university educators. Nevertheless, the use of digital formats has been predominantly for content delivery, with comparatively less emphasis on interactive or collaborative learning activities, including audience response systems, learning apps and simulation-based applications. These, therefore, have yet to reach their full potential. The reason for this could be a lack of didactic innovation (Tolks et al., \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2016\u003c/span\u003e, Kwon et al. \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2021\u003c/span\u003e, Marchwacka et al. \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). Regarding the continued use of digital teaching methods in the post-pandemic era, a mixed response was observed among teaching professionals. While just over half of respondents expressed a positive view, a significant proportion expressed skepticism or reluctance. With regard to the question: \u0026lsquo;If you summarize your knowledge and experience with digital learning - how do you rate digital learning?\u0026rsquo;, the statements digital teaching and learning opportunities improve access for physically impaired learners and promote the attractiveness of the university were rated more negatively in the second survey than in the first; all other statements received more approval.\u003c/p\u003e \u003cp\u003eFurthermore, despite the obvious benefits, a strong perception of digital teaching as time-consuming, coupled with unclear institutional recognition and support mechanisms, emerges as a significant barrier. These perceptions point to the critical need for structural reforms in institutional policy, in particular the clarification and recognition of digital teaching efforts in workload calculations and the provision of robust didactic and technical support (M\u0026uuml;ller et al., \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2018\u003c/span\u003e; Benning et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2020\u003c/span\u003e, Tudor et al. 2021).\u003c/p\u003e \u003cp\u003eUniversity educators have reservations about the effectiveness of digital teaching methods in reducing attrition rates and enhancing personalized learning experiences (Gilch et al., \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2019\u003c/span\u003e, Schaal et al. \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2022\u003c/span\u003e, Hempel et al. \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). This skepticism highlights the need for additional research that is clearly and firmly grounded in empirical evidence, and that focuses specifically on the efficacy of digital teaching methodologies. And research to explore the underlying motivational factors and barriers to the use of innovative digital methods and tools (Marchwacka et al. \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2022\u003c/span\u003e, Jeffries et al. \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2022\u003c/span\u003e, Bond et al. \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). With the increasing use of AI technologies in health sciences education, there is also a growing need to further develop the digital skills of faculty (Meng et al., 2024, Burr et a. 2024). As a result, institutions will be compelled to integrate ethical and legal dimensions more intensively into continuing education programmes, in addition to technical aspects.\u003c/p\u003e"},{"header":"Recommendations","content":"\u003cp\u003eIn order to advance digital higher education in healthcare, it is essential that institutions priorities targeted faculty training in interactive digital tools and methodologies. In order to facilitate the sustainable and successful integration of digital teaching methods, it is imperative that specific didactic qualifications, digital competence and institutional frameworks are in place (Joint Research Centre 2022). Moreover, the implementation of systematic evaluation strategies is imperative to assess the long-term impacts of digital teaching on student learning outcomes. The exploration and integration of emerging technologies, such as artificial intelligence, has the potential to significantly enhance educational effectiveness in healthcare professions.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cem\u003eEthics approval and consent to participate\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAll subjects gave their informed consent for inclusion before they participated in the study. The study was conducted in accordance with the Declaration of Helsinki. The online survey was conducted among members of the Teaching Section of the German Society for Public Health (DGPH), the Digitization Committee of the Society for Medical Education (GMA), the Education and Counseling Section of the German Nursing Association (DGP), and the Teaching Working Group of the German Society for Medical Sociology (DGMS). The invitation to participate and initial information about the survey were included in the regular newsletters of the aforementioned societies. All participants in this study were informed about the purpose, form, and scope of the collection and processing. Prior to participation, participants had to clearly agree to the data protection information on the landing page of the online survey (informed consent). Otherwise, participant was redirected to the end of the questionnaire and excluded from the survey. Participation was voluntary, opting out was possible at any time, and the survey was anonymous. An ethics vote is not required according to §13 of the German Data Protection Regulation (DSGVO) in conjunction with the \"Guidelines for Online Surveys\" of the Association of German Market and Social Research Institutes. Participants were asked to evaluate the teaching and learning conditions during the COVID-19 pandemic. The survey was conducted in line with the Bertelsmann Foundation's \"Monitor Digital Education\" from 2017. The monitor covers the various forms of digital learning in schools, vocational training, higher education and continuing education. The survey does not include patient or disease data or information on the health status of respondents. Studies of the human body were not conducted. As a result of the study, conclusions are drawn as to how teaching at universities can be better designed in the future.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eConsent for publication\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAvailability of data and materials\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAll data generated or analyzed during this study are included in the supplementary information files.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eCompeting interests\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eFunding\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAuthors' contributions\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAll authors contributed in writing the manuscript. TS was programming the Online-Survey and did descriptive statistics. JK and DT developed the questionnaire. MW did statistical analysis and proofread of the manuscript. TS, MW, DT and JK approved the final version of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAcknowledgements\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eWe thank all participants for their participation and realization of the study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eBurr P, Kumar A, Young T. The potential of AI text-to-image generation in medical education: the educator and students\u0026apos; perspective. In: Beckingham S, Lawrence J, Powell S, Hartley P, editors. Using Generative AI Effectively in Higher Education. Milton Park, UK. Routledge; 2024.\u003c/li\u003e\n\u003cli\u003eBenning NH, Haag M, Knaup P, Krefting D, Rienhoff O, Suhr M, u. a. Digital teaching as an instrument for cross-location teaching networks in medical informatics: opportunities and challenges. GMS J Med Educ. 16. November 2020;37(6):Doc56. \u003c/li\u003e\n\u003cli\u003eBond M, Buntins K, Bedenlier S, Zawacki-Richter O, Kerres M. Mapping research in student engagement and educational technology in higher education: a systematic evidence map. In: International Journal of Educational Technology in Higher Education 17 (2020) 1, S. 1-30\u003c/li\u003e\n\u003cli\u003eCheng L, Ritzhaupt AD, Antonenko P. Effects of the flipped classroom instructional strategy on students\u0026rsquo; learning outcomes: a meta-analysis. Education Tech Research Dev. 2019;67:793\u0026ndash;824.\u003c/li\u003e\n\u003cli\u003eDFG. Leitlinien zur Sicherung guter wissenschaftlicher Praxis. Bonn: Deutsche Forschungsgemeinschaft; 2019\u003c/li\u003e\n\u003cli\u003eDost S, Hossain A, Shehab M, Abdelwahed A, Al-Nusair L. Perceptions of medical students towards online teaching during the COVID-19 pandemic: a national cross-sectional survey of 2721 UK medical students. BMJ Open 2020;10:e042378. https://doi.org/10.1136/bmjopen-2020-042378\u003c/li\u003e\n\u003cli\u003eFontaine G, Cossette S, Maheu-Cadotte MA, Mailhot T, Desch\u0026ecirc;nes MF, Mathieu-Dupuis G. Effectiveness of Adaptive E-Learning Environments on Knowledge, Competence, and Behavior in Health Professionals and Students: Protocol for a Systematic Review and Meta-Analysis. JMIR Res Protoc. 2017;6:e128.\u003c/li\u003e\n\u003cli\u003eGilch H, Beise AS, Krempkow R, M\u0026uuml;ller M, Stratmann F, Wannemacher K. Digitalisierung der Hochschulen. Ergebnisse einer Schwerpunktstudie f\u0026uuml;r die Expertenkommission Forschung und Innovation. Berlin: HIS-Institut f\u0026uuml;r Hochschulentwicklung; 2019.\u003c/li\u003e\n\u003cli\u003eHempel G, Weissenbacher A, Stehr SN. [COVID-19: a chance for digitalization of teaching? : Report of experiences and results of a survey on digitalized teaching in the fields of anesthesiology, intensive care, emergency, pain and palliative medicine at the University of Leipzig]. Anaesthesist. 2022;71:340\u0026ndash;9.\u003c/li\u003e\n\u003cli\u003eHew KF, Lo CK. Flipped classroom improves student learning in health professions education: a meta-analysis. BMC Medical Education. 2018;18:38.\u003c/li\u003e\n\u003cli\u003eJeffries P R, Bushardt R L, DuBose-Morris R, Hood C, Kardong-Edgren S, Pintz C, Posey L \u0026amp; Sikka N. The role of technology in health professions education during the COVID-19 pandemic. Academic Medicine, 2022;97(3), S104\u0026ndash;S109. https://doi.org/10.1097/ACM.0000000000004523\u003c/li\u003e\n\u003cli\u003eJoint Research Centre, J. C.R.: DigComp 2.2 - the Digital Competence Framework for Citizens. With new examples of knowledge, skills and attitudes. Luxembourg 2022. URL: https://op.europa.eu/en/publication-detail/-/publication/50c53c01-abeb-11ec-83e1-01aa75ed71a1/language-en/format-PDF/source-280137285\u003c/li\u003e\n\u003cli\u003eKononowicz AA, Woodham LA, Edelbring S, Stathakarou N, Davies D, Saxena N, et al. Virtual Patient Simulations in Health Professions Education: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration. J Med Internet Res. 2019;21:e14676.\u003c/li\u003e\n\u003cli\u003eKwon S, Kim W, Bae C, Cho M, Lee S, Dreamson N. The identity changes in online learning and teaching: instructors, learners, and learning management systems. Int J Educ Technol High Educ. 2021;18(1):67. \u003c/li\u003e\n\u003cli\u003eKumar A, Sarkar M, Davis E, Morphet J, Maloney S, Ilic D, \u0026amp; Palermo C. Impact of the COVID-19 pandemic on teaching and learning in health professional education: A mixed methods study protocol. BMC Medical Education, 2021;21(1), 439. https://doi.org/10.1186/s12909-021-02871-w\u003c/li\u003e\n\u003cli\u003eMarchwacka, M.A., Kugler, J., Schaal, T., Tolks, D. (2022): Digitale Hochschullehre im ersten COVID-19-Semester. Ergebnisse einer Untersuchung in Public Health, Medizin und Pflege. In: Pr\u0026auml;v Gesundheitsf \u003cstrong\u003e18\u003c/strong\u003e, 22\u0026ndash;29 (2023). https://doi.org/10.1007/s11553-022-00937-1.\u003c/li\u003e\n\u003cli\u003eMeng W, Lei Y, Liu C, Pan N, Pang X, \u0026amp; Zhu Y. A systematic review of the effectiveness of online learning in higher education during the COVID-19 pandemic period. 2024;Frontiers in Education, 8.\u003c/li\u003e\n\u003cli\u003eM\u0026uuml;ller C, F\u0026uuml;ngerlings S, Tolks D. Teaching load \u0026ndash; a barrier to digitalisation in higher education? A position paper on the framework surrounding higher education medical teaching in the digital age using Bavaria, Germany as an example. GMS J Med Educ. 2018;35(3):Doc34. \u003c/li\u003e\n\u003cli\u003eMüller-Eiselt R (2017) Materialsammlung Monitor Digitale Bildung. https://www.bertelsmann-stiftung.de/de/unsere-projekte/teilhabe-in-einer-digitalisierten-welt/monitor/materialsammlung-monitor-digitale-bildung. Accessed: May 4, 2025\u003c/li\u003e\n\u003cli\u003eSchaal T, Marchwacka MA, Tolks D, Kugler J. Change and adoption of digital learning formats during the COVID-19 pandemic. A trend study from Germany. IJLTET. SPECIAL ISSUE - ICTIMESH \u0026ndash; 2022: 101-106.\u003c/li\u003e\n\u003cli\u003eSchmid U, Goertz L, Radomski S, Thom S, Behrens J. Monitor Digitale Bildung. Die Hochschulen im digitalen Zeitalter. G\u0026uuml;tersloh: Bertelsmann Stiftung; 2017.\u003c/li\u003e\n\u003cli\u003eStrelan P, Osborn A, Palmer E. The flipped classroom: A meta-analysis of effects on student performance across disciplines and education levels. Educational Research Review. 2020;30.\u003c/li\u003e\n\u003cli\u003eTolks D, Sch\u0026auml;fer C, Raupach T, Kruse L, Sarikas A, Gerhardt-Sz\u0026eacute;p S, et al. An Introduction to the Inverted/Flipped Classroom Model in Education and Advanced Training in Medicine and in the Healthcare Professions. GMS J Med Educ. 2016;33:Doc46.\u003c/li\u003e\n\u003cli\u003eTudor Car L, Kyaw BM, Nannan Panday RS, van der Kleij R, Chavannes N, Majeed A, Car J\u003cbr\u003eDigital Health Training Programs for Medical Students: Scoping Review\u003cbr\u003eJMIR Med Educ 2021;7(3):e28275 doi: 10.2196/28275\u003c/li\u003e\n\u003cli\u003evan Alten DCD, Phielix C, Janssen J, Kester L Effects of flipping the classroom on learning outcomes and satisfaction: A meta-analysis. Educational Research Review. 2019;28.\u003c/li\u003e\n\u003cli\u003eWinde M, Werner S, Gumbmann B, Hieronimus S. Hochschulen, Corona und jetzt? Essen: Stifterverband; 2020.\u003c/li\u003e\n\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":"digital transformation, digital teaching, higher education","lastPublishedDoi":"10.21203/rs.3.rs-6706933/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6706933/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThe present research project utilized cross-sectional surveys administered to faculty members from the fields of medical sciences, public health and nursing. The objective of the present study was to explore perceptions, experiences and future intentions regarding digital teaching methodologies. It is evident that digital platforms such as Zoom, Moodle and MS Teams have become widely utilized tools, primarily for the dissemination of content as opposed to facilitating interactive engagement. The faculty acknowledged the advantages of enhanced accessibility and heightened institutional attractiveness. However, the study also identified substantial challenges, including a considerable time investment, inadequate institutional support, and uncertainty regarding the efficacy of digital methods on learning outcomes. The results of the study demonstrate the importance of strategic institutional reforms, targeted didactic training, and clear policies that recognize the contribution of digital teaching to the sustainable enhancement of educational practices in healthcare disciplines.\u003c/p\u003e","manuscriptTitle":"Transforming Educator Expectations in Public Health, Nursing, and Medicine: A Two-Phase Survey on Digital Tools in Education","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-04 15:22:57","doi":"10.21203/rs.3.rs-6706933/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-09-05T05:41:49+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-09-04T18:57:33+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"316957045761182016058803583120555651021","date":"2025-08-21T12:57:00+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-07-28T16:30:50+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"313234808928080394392373458645533194895","date":"2025-07-23T14:09:55+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-07-16T14:30:36+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"135386873958345421163617438114339809779","date":"2025-07-13T15:15:06+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-07-02T12:34:17+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-06-24T19:15:11+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-05-30T14:26:18+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-05-29T15:58:13+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Medical Education","date":"2025-05-29T15:55:35+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":"8db3887b-398f-45a3-bf58-e893f10b57ec","owner":[],"postedDate":"July 4th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-12-15T16:08:46+00:00","versionOfRecord":{"articleIdentity":"rs-6706933","link":"https://doi.org/10.1186/s12909-025-08406-x","journal":{"identity":"bmc-medical-education","isVorOnly":false,"title":"BMC Medical Education"},"publishedOn":"2025-12-08 15:59:06","publishedOnDateReadable":"December 8th, 2025"},"versionCreatedAt":"2025-07-04 15:22:57","video":"","vorDoi":"10.1186/s12909-025-08406-x","vorDoiUrl":"https://doi.org/10.1186/s12909-025-08406-x","workflowStages":[]},"version":"v1","identity":"rs-6706933","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6706933","identity":"rs-6706933","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}