Blended Learning Challenges and the Contribution of Self-Regulated Learning to Health Care Students’ Resilience: A Cross-Sectional Study

Muhammad Andre Sugiharto; Rustiana Tasya Ariningpraja; Retno Lestari

doi:10.35445/alishlah.v17i3.7438

Blended Learning Challenges and the Contribution of Self-Regulated Learning to Health Care Students’ Resilience: A Cross-Sectional Study

Muhammad Andre Sugiharto, Rustiana Tasya Ariningpraja, Retno Lestari

Abstract

Health science students face significant challenges in post-COVID-19 learning, including time management difficulties, technological adaptation, and academic pressure. Blended learning, now a standard model in health education, demands strong self-regulated learning (SRL) and resilience for academic success and well-being. This cross-sectional study investigated the relationship between SRL and academic resilience (ARS) among 302 undergraduate students from various health disciplines at Universitas Brawijaya. Data were collected using validated instruments: the Self-Regulation for Learning Questionnaire and the Academic Resilience Scale (ARS-30). Descriptive statistics and Pearson correlation analysis were used to analyze the data. Findings revealed that 68.5% of students exhibited high SRL, and 68.9% demonstrated high ARS. The correlation analysis showed a statistically significant moderate positive relationship between SRL and ARS (r = 0.477, p < 0.001). Students with higher levels of self-regulation were more likely to demonstrate greater resilience in navigating academic challenges within the blended learning environment. The results underscore the critical role of SRL in fostering academic resilience among healthcare students. These findings suggest that targeted strategies to enhance SRL—such as goal setting, time management training, and reflective practices—can improve students’ ability to adapt and persist in blended learning contexts. Educational institutions should implement structured learning support and psychological resilience programs to support student success.

Keywords

self-regulated learning; academic resilience; blended learning; healthcare education; student success

Full Text:

PDF

References

Abram, M. D., & Jacobowitz, W. (2021). Resilience and burnout in healthcare students and inpatient psychiatric nurses: A between-groups study of two populations. Archives of Psychiatric Nursing, 35(1), 1–8. https://doi.org/10.1016/j.apnu.2020.10.008

Ang, W. H. D., Shorey, S., Hoo, M. X. Y., Chew, H. S. J., & Lau, Y. (2021). The role of resilience in higher education: A meta-ethnographic analysis of students’ experiences. Journal of Professional Nursing, 37(6), 1092–1109. https://doi.org/10.1016/j.profnurs.2021.08.010

Artuch-Garde, R., González-Torres, M. del C., de la Fuente, J., Vera, M. M., Fernández-Cabezas, M., & López-García, M. (2017). Relationship between Resilience and Self-regulation: A Study of Spanish Youth at Risk of Social Exclusion. Frontiers in Psychology, 8. https://doi.org/10.3389/fpsyg.2017.00612

Balakrishnan, A., Nair, S., Kunhikatta, V., Rashid, M., Unnikrishnan, M. K., Jagannatha, P. S., Chandran, V. P., Khera, K., & Thunga, G. (2021). Effectiveness of blended learning in pharmacy education: An experimental study using clinical research modules. PLoS ONE, 16(9 September), 1–13. https://doi.org/10.1371/journal.pone.0256814

Ballouk, R., Mansour, V., Dalziel, B., McDonald, J., & Hegazi, I. (2022). Medical students’ self-regulation of learning in a blended learning environment: a systematic scoping review. Medical Education Online, 27(1). https://doi.org/10.1080/10872981.2022.2029336

Broadbent, J., Panadero, E., Lodge, J. M., & Fuller-Tyszkiewicz, M. (2023). The self-regulation for learning online (SRL-O) questionnaire. Metacognition and Learning, 18(1), 135–163. https://doi.org/10.1007/s11409-022-09319-6

Cassidy, S. (2016). The Academic Resilience Scale (ARS-30): A New Multidimensional Construct Measure. Frontiers in Psychology, 7. https://doi.org/10.3389/fpsyg.2016.01787

Ching, S. S. Y., Cheung, K., Hegney, D., & Rees, C. S. (2020). Stressors and coping of nursing students in clinical placement: A qualitative study contextualizing their resilience and burnout. Nurse Education in Practice, 42, 102690. https://doi.org/10.1016/j.nepr.2019.102690

Chitra, E., Hidayah, N., Chandratilake, M., & Nadarajah, V. D. (2022). Self-Regulated Learning Practice of Undergraduate Students in Health Professions Programs. Frontiers in Medicine, 9(February), 1–11. https://doi.org/10.3389/fmed.2022.803069

Coffman, S., & Taber, A. (2024). Developing Self-Regulated Learners in Nursing. Journal of Nursing Education, 63(X), 1–4. https://doi.org/10.3928/01484834-20240521-02

Cronje, J. C. (2020). Towards a new definition of blended learning. Electronic Journal of E-Learning, 18(2), 114–135. https://doi.org/10.34190/EJEL.20.18.2.001

Donnellan, C., Chakkittakandy, D., & Lydon, C. (2024). Conceptual Considerations for Understanding Resilience in Healthcare Students. Nursing Open, 11(10), e70061. https://doi.org/10.1002/nop2.70061

G. Esternon, C. E., R. Lopres, J., L. Gomez, B., M. Lopres, G., P. Pilapil, G. M., N. Ramirez, W., M. Anjao, R., & F. Apatan, C. (2023). Instructional Readiness and Stress Level of Special Education Teachers on Blended Learning Approach during COVID-19: Implications for Post-Pandemic. International Journal of Science and Management Studies (IJSMS), 47–72. https://doi.org/10.51386/25815946/ijsms-v6i6p105

Hamaker, E. L. (2022). The Curious Case of the Cross-Sectional Correlation. Multivariate Behavioral Research, 59(6), 1111–1122. https://doi.org/10.1080/00273171.2022.2155930

Hwang, Y., & Oh, J. (2021). The relationship between self-directed learning and problem-solving ability: The mediating role of academic self-efficacy and self-regulated learning among nursing students. International Journal of Environmental Research and Public Health, 18(4), 1–9. https://doi.org/10.3390/ijerph18041738

Iqbal, J., Asghar, M. Z., Ashraf, M. A., & Yi, X. (2022). The Impacts of Emotional Intelligence on Students’ Study Habits in Blended Learning Environments: The Mediating Role of Cognitive Engagement during COVID-19. Behavioral Sciences, 12(1), 14. https://doi.org/10.3390/bs12010014

Jansen, R. S., van Leeuwen, A., Janssen, J., Conijn, R., & Kester, L. (2020). Supporting learners’ self-regulated learning in Massive Open Online Courses. Computers and Education, 146(February 2019). https://doi.org/10.1016/j.compedu.2019.103771

Kakoschke, N., Hassed, C., Chambers, R., & Lee, K. (2021). The importance of formal versus informal mindfulness practice for enhancing psychological wellbeing and study engagement in a medical student cohort with a 5-week mindfulness-based lifestyle program. PLoS ONE, 16(10 October), 1–15. https://doi.org/10.1371/journal.pone.0258999

Leinster, S. J., Pereira, J. H., Down, S., & Simpson, A. D. (2021). Blended Learning in Healthcare Education. Medical Research Archives, 9(8). https://doi.org/10.18103/mra.v9i8.2527

Orines, R. D., Alomia, K. A. A., Canoy, J. M. L., Pascual, K. M. D. J., Pol-ot, M. A. I., Servas, A. F. R., & Tan, S. D. T. (2023). Stress and Resilience as Predictors of Quality of Life among Healthcare Students. Asian Journal of Research in Education and Social Sciences, 5(2), 81–89. https://doi.org/10.55057/ajress.2023.5.2.9

Petty, J. (2013). Interactive, technology-enhanced self-regulated learning tools in healthcare education: A literature review. Nurse Education Today, 33(1), 53–59. https://doi.org/10.1016/j.nedt.2012.06.008

Posey, L., & Pintz, C. (2017). Transitioning a bachelor of science in nursing program to blended learning: Successes, challenges & outcomes. Nurse Education in Practice, 26, 126–133. https://doi.org/10.1016/j.nepr.2016.10.006

Practices, L., & Aravind, B. S. (2024). Exploring the Challenges and Opportunities of Blended Learning in a Technology – Enabled Education Environment. 1.

Rafi, A., Anwar, M. I., Younas, A., & Manzoor, S. (2022). Paradigm shift in medical education due to the COVID-19 pandemic: guidelines for developing a blended learning curriculum in medical education. F1000Research, 11, 37. https://doi.org/10.12688/f1000research.74779.2

Rowe, M., Frantz, J., & Bozalek, V. (2012). The role of blended learning in the clinical education of healthcare students: A systematic review. Medical Teacher, 34(4). https://doi.org/10.3109/0142159X.2012.642831

Saber, H., Manaf, R. A., Basman, A. T., Sanip, S., Yein, L. P., Kamalludeen, R., Ibrahim, R., & Amin-Nordin, S. (2022). Challenges and Barriers of Blended Learning Among Asian Health Sciences Students: A Pilot Study. Education in Medicine Journal, 14(1), 1–16. https://doi.org/10.21315/eimj2022.14.1.1

Van Laer, S., & Elen, J. (2019). The effect of cues for calibration on learners’ self-regulated learning through changes in learners’ learning behaviour and outcomes. Computers and Education, 135(July 2018), 30–48. https://doi.org/10.1016/j.compedu.2019.02.016

Vineesha, V., Monteiro, R. F., & Prasad, V. (2024). Well-Being and Resilience among Undergraduate Students at a Selected University. Journal of Health and Allied Sciences NU, 14(02), 248–252. https://doi.org/10.1055/s-0043-1770069

Wang, L. (2021). The Role of Students’ Self-Regulated Learning, Grit, and Resilience in Second Language Learning. Frontiers in Psychology, 12. https://doi.org/10.3389/fpsyg.2021.800488

Wang, T., Li, S., Tan, C., Zhang, J., & Lajoie, S. P. (2023). etacognitive aCognitive load patterns affect temporal dynamics of self-regulated learning behaviors, metacogntive judgments, and learning achievements. Computers and Education, 207(August), 104924. https://doi.org/10.1016/j.compedu.2023.104924

Yan, Z. (2020). Self-assessment in the process of self-regulated learning and its relationship with academic achievement. Assessment and Evaluation in Higher Education, 45(2), 224–238. https://doi.org/10.1080/02602938.2019.1629390

Yang, R., Gao, Y. F., & Ji, Z. T. (2023). The relationship between self-regulated learning, mindful agency, and psychological resilience in Chinese master of nursing specialists: A cross-sectional study. Frontiers in Psychology, 14(March), 1–6. https://doi.org/10.3389/fpsyg.2023.1066806

Zhang, J.-Y., Liu, Y.-J., Shu, T., Xiang, M., & Feng, Z.-C. (2022). Factors associated with medical students’ self-regulated learning and its relationship with clinical performance: a cross-sectional study. BMC Medical Education, 22(1), 128. https://doi.org/10.1186/s12909-022-03186-0

Zimmerman, B. J. (2013). From Cognitive Modeling to Self-Regulation: A Social Cognitive Career Path. Educational Psychologist, 48(3), 135–147. https://doi.org/10.1080/00461520.2013.794676

DOI: https://doi.org/10.35445/alishlah.v17i3.7438