1. Introduction
The worldwide incidence of COVID-19 cases kept increasing after the World Health Organization (WHO) declared COVID-19 as a pandemic disease on 11 March 2020 [
1]. The pandemic started with an outbreak of pneumonia of unknown origin that was reported in December 2019 in Wuhan, China [
2]. The WHO and the Centers for Disease Control and Prevention (CDC) declared COVID-19 a disease caused by a newly discovered coronavirus strain named SARS-CoV-2 [
3]. The COVID-19 is extremely contagious, and it has several potential transmission routes; mainly via respiratory droplets from one person to another produced during coughing and sneezing [
4]. Preventive measures were needed to reduce the number of cases and to control the spread of the disease. Preventative measures include wearing facial masks and gloves, covering the mouth when coughing, washing the hands with soap for 20 s, maintaining a distance of at least one meter from others, and adhering to curfews when needed [
2].
In addition to the healthcare effects that the COVID-19 pandemic caused, other aspects including tertiary education were highly affected as well [
5]. The learning process during the COVID-19 pandemic underwent a lot of changes due to the strict restrictions of the lockdown that led to universities’ closure. Therefore, education was provided through sustainable digital educational platforms in most countries [
6,
7,
8,
9]. The closure of universities placed extraordinary challenges on the governments [
10]. The educational authorities worked hard to meet the educational needs of the students during the transition to online learning. Several urgent policies were implemented by the policymakers in order to maintain good educational services while coping with the pandemic [
11].
The COVID-19 inflicted a great amount of stress on both students and academics, mainly due to the second shift that took place in the methods of education delivered. Changing those educational strategies from face-to-face education to complete online education needed large efforts and adaptation to change by both teachers and students. The results of a review published in 2021 showed that psychological symptoms following the closure of universities and other educational institutions and the need to adapt to new teaching modalities have led to 30% of teachers suffering from stress [
12]. The impact of digital technologies during the pandemic not only affected the level of stress among educators but also negatively affected their motivation to deliver their role [
13]. Digital competencies of academics at university played an important role in their adaptation of the skills needed to shift to a digital learning environment enforced during and following the pandemic [
14].
In Turkey, the Ministry of National Education (MoNE) reinforced the infrastructure of the digital education portal and the education informatics network. The MoNE also joined forces with the Turkish Radio and Television Corporation (TRT) in order to perform the courses via these online platforms and to establish an effective online educational system. Since these dynamic platforms were crucial for learning, the MoNE provided urgent educational material such as curriculum-based videos and e-books. To ensure learning continuity, other services were provided including the ability of the students to access free internet and to access live courses. Moreover, a helpline for psychosocial support was provided for students and a program for professional development for teachers was developed and put into action [
11]. Regarding medical education in Turkey, the faculties promoted active self-learning education, and reduced the classic lessons in order to convert the education into individualized virtual education [
15].
In Jordan, policymakers envisaged the transition to distance education [
16]. Jordan’s Ministry of Higher Education and Scientific Research (MHESR) commanded all education universities to stop on-campus education and transform to online learning [
17]. Educational institutions had to scale up the existing distance education modalities by using mixes of technology via the internet to provide online platforms for learning. The platforms helped the students and the lecturers in explaining the course contents in a simple and effective way, made long-distance discussion viable, promoted distance collaborations, and online exams [
18]. Such dramatic changes to the tertiary educational system require a thorough investigation of the effect of the COVID-19 pandemic on the learning process among university students in Turkey and Jordan.
There are many similarities between Turkey and Jordan with regards to the educational system in both countries. Both countries support public (funded by the government) and private education (costs covered mostly by the student), offering numerous graduates and postgraduate degrees. Both countries went through a lockdown during the COVID-19 pandemic, shifting their education to a complete online system [
19,
20,
21]. In addition, both countries have taken measures to keep a certain percentage of their tertiary education online. Both countries offer great opportunities for tertiary education not only to their residents, but to foreign students as well. The number of non-Jordanian students who are studying in Jordan reached 44,000 in 2020 [
22]. A high number of non-Turkish students have also been studying in Turkey, as it was documented that over 125,000 students from outside of Turkey joined the universities there in 2018 [
23]. Student exchanges between both countries have also been vibrant [
24].
The aim of this study was to assess the effect of the coronavirus pandemic on the learning process among the students in Turkey and Jordan, and to compare the implications of the changes that took place due to the transition to online education in both environments.
2. Method
2.1. Study Design
The study objectives were addressed using a descriptive cross-sectional online survey developed by the research team. A focused group meeting was also conducted to look further into certain aspects of the study.
This mixed-method of data collection was used to assess the effect of the COVID-19 pandemic on the learning process among students living in Turkey and Jordan, and to compare the differences between the two countries in order to provide a complete picture of the situation in these two educational systems.
2.2. Participant Recruitment
The study was carried out from May to October 2021. Eligible participants were students enrolled at universities in both countries.
Participants were informed that their participation in the current study was voluntary. Informed consent was obtained from all individual participants included in this study.
2.3. Survey Development
The survey was developed by the research team by formulating relevant questions that would answer the objectives of this study. To assess face validity, the first prepared draft of the survey was evaluated by expert academics (n = 3) who have previous experience in related fields such as clinical research and education.
The researchers evaluated the questions’ comprehension, relevance, and word clarity. Questions in the survey found unclear, difficult to comprehend, or irrelevant were removed. The feedback provided was considered by the research members and changes were incorporated in order to develop a new version of the survey. The survey was trialed through a pilot study preceding the main study, with a group of 25 Turkish and 25 Jordanian students. Changes were incorporated to improve the readability and understandability, as well as to ensure its applicability to the two populations.
The final version of the survey was organized into two main sections (
Supplementary Materials File S1). The first section of the study’s survey included information regarding the participants’ demographic data, and other information such as university category, educational level, social status, smoking status, intake of caffeine, and sleeping patterns during the COVID-19 pandemic. The second section of the study’s survey included items aimed at assessing the learning process during the pandemic and exploring students’ beliefs regarding online education. The second section consisted of 11 close-ended questions, 7 out of the 11 questions were answered using a 5-point Likert scale (Excellent, Very good, Good, Fair, and Not good). These seven questions were set to investigate how the students ranked their attendance to lectures during the semester before their participation in this study, their evaluation of the theory courses they attended that semester compared to the year before the COVID-19 pandemic, students’ Grade Point Averages (GPA) before and after the pandemic, how many hours on average they used to study daily, evaluation of the practical courses they received, evaluation of the different exams they completed, their relationship with their teachers before and after the COVID-19 pandemic, and the effect of online learning on students’ last semester GPA compared to last year’s second semester. Exploratory factor analysis justifying the use of the seven items as part of the same factor/construct in the survey was conducted. The Cronbach’s alpha coefficient for this part of the survey was found to be 0.82, which indicates that the survey has good internal consistency (reliability). The survey was administered in Arabic in Jordan and in Turkish in Turkey. Translation and back translation of the survey was conducted to ensure accuracy of the translation.
2.4. Survey Implementation
Study participants were recruited through social media (mainly Facebook and WhatsApp); those willing to consider participation were asked to open a link to initially view ethics committee-approved information about the study and then proceed to the survey. The research team designed the survey to take less than 5 min to complete. Once participants completed the survey, they pressed the submission button, and their answered surveys were returned to the research team.
2.5. Statistical Analysis
Following data collection, the survey responses were coded and entered into a customized database using the Statistical Package for the Social Sciences (SPSS), Version 24.0 (IBM Corp., Armonk, New York, USA). Checking for data normality was carried out using the Shapiro–Wilk test (with p-value ≥ 0.05 indicating a normally distributed continuous variable). The continuous variables were documented as mean (SD). Data that were not normally distributed were analyzed using the Mann–Whitney U test and Wilcoxon signed rank test for comparison purposes. Categorical variables were documented as proportions (%) and were analyzed using Pearson’s Chi-square test. All p-values of less than 0.05 were considered statistically significant. Data from the focus group conversation were summarized thematically.
The dependent variable was the seven questions included in the learning process during the pandemic assessment. The independent variables included the study countries (Turkey and Jordan), and demographics (age, gender, marital status, living place, nationality, educational level, study field, type of university, having a scholarship, smoking, caffeine intake, sleeping hours, and sleeping pattern).
2.6. Focus Group Implemetation
The focused group meeting was conducted as participants were randomly recruited to participate. Students who attended the focus group session were prompted to provide further insight regarding the impact of the coronavirus pandemic on the learning process. Several open-ended questions were prepared by the research team. The following questions were answered and discussed by the students:
What are the advantages and disadvantages of online learning?
Do you prefer online learning over face-to-face learning or not?
How did online learning affect your grades?
What are the difficulties you faced in the online learning process during the COVID-19 pandemic?
What approaches helped in improving your academic performance during the COVID-19 pandemic?
How did you adjust your study habits while learning remotely?
How did the online learning affect your learning short term and long term?
2.7. Ethical Approval
Ethics approval for the study was obtained from the Faculty of Pharmacy, Applied Science Private University (study approval number: 2021-PHA-32).
3. Results
A total of 214 students participated in this study (Turkey = 101; Jordan = 113 students). The study participants from Turkey had a mean age of 21.89 (SD = 3.013) years, similar to that of the Jordanian students (mean age = 20.98 (SD = 1.923)). In both countries, most of the participants were female, single, living in a city-type zone, and undergraduates.
Among Turkish students, most of the students were of Turkish nationality (88.1%), studying a specialty related to humanities (61.4%), from an endowment university (94.0%), and had a scholarship that covered the tuition fees, the accommodation on-campus fees, and with living expenses per month (47.5%). On the other hand, among the Jordanian students, most of the students were of Jordanian nationality (74.3%), studying a specialty related to health (63.7%), and from a private university (85.0%). The detailed demographic characteristics of the study participants (
n = 214) are shown in
Table 1.
Table 2 shows students’ lifestyle (smoking, intake of caffeine, sleeping hours, and sleeping pattens) during the COVID-19 pandemic. The majority of the students were non-smokers in both Turkey and Jordan (92.1%, and 80.4%, respectively).
Regarding caffeine intake among the Turkish and Jordanian students during the COVID-19 pandemic, 44.5% and 42.5% reported drinking less than two cups of coffee a day, respectively, 13.9% and 27.4% reported drinking 2 cups of coffee or more a day, while 41.6% and 30.1% did not drink coffee.
Regarding the students’ sleep patterns during the pandemic, most of the students were sleeping during the night in Turkey and in Jordan (88.1%, and 59.3%, respectively). A significant difference was observed between Turkish and Jordanian students regarding their sleeping patterns (
p-value < 0.001;
Table 2). Among Turkish students, almost 75% of them reported that they were sleeping more than eight hours, while only 24.8% of the Jordanian students reported that they were sleeping more than eight hours.
Table 3 shows the answers of the students regarding the learning strategy during the COVID-19 pandemic. Ranking the attendance to classes/lectures showed that 60.4% of the Turkish students and 56.7% of the Jordanian students thought it was ‘excellent’ or ‘very good’ or ‘good’.
Regarding the theory courses, the percentage of Turkish students who evaluated the online learning process as ‘excellent’ or ‘very good’ or ‘good’ was 56.4%, while a lower proportion was reported by the Jordanian students (50.4%).
Many Turkish students (50.4%) ranked the exams as ‘excellent’ or ‘very good’ or ‘good’, and almost the same results were observed among the Jordanian students (47.8%).
With regards to the practical training, more than half of the Turkish students (57.5%) ranked their experience in practical training as ‘excellent’ or ‘very good’ or ‘good’, while a lower proportion was reported by Jordanian students (47.7%).
The impact of the learning process during the COVID-19 pandemic on the students’ relationship with their teachers showed that 47.5% of the Turkish students and 50.5% of the Jordanian students believed the relationship was ‘excellent’ or ‘very good’ or ‘good’.
With regards to the current semester’s Grade Point Average (GPA) compared to the GPA of last year’s second semester, the results showed that more than half of the Turkish students (55.5%) reported that it had a positive effect on their grades, while a higher result was reported by Jordanian students (64.6%).
Figure 1 shows students’ assessment of practical courses during online learning, the proportion of Turkish students who ranked the practical courses as ‘excellent’ or ‘very good’ or ‘good’ was 43.6%, while a lower percentage was observed among the Jordanian students (40.7%).
Figure 2 shows students’ assessment of the Grade Point Average (last semester) compared to last year’s second semester during the online learning. The percentage of students who ranked it as “Excellent” was three higher among Jordanian students (15.0%) compared to the Turkish students (4.0%).
A significant difference was observed between the Turkish and Jordanian students regarding their evaluation of the practical courses (p-value = 0.005, Chi-square test) and the impact of the online learning on their GPAs (p-value = 0.015, Chi-square test).
As listed in
Table 4, the GPA mean, among the Turkish students, slightly increased in 2020–2021 compared to the same time in the 2019–2020 academic year (89.45 (SD = 9.02) vs. 85.22 (SD = 11.01)). Moreover, the same result was observed among Jordanian students (83.03 (SD = 6.65) vs. 81.63 (SD = 8.78)).
The total mean hours on average used for studying decreased among Turkish students (3.91 (SD = 2.199) vs. 3.55 (SD = 2.171)), and among Jordanian students (4.60 (SD = 2.52) vs. 4.35 (SD = 2.81)) comparing the same semester in 2020–2021 to the 2019–2020 academic year (
Table 4).
As shown in
Table 4, a significant difference was observed between Turkish and Jordanian students regarding their GPA for 2019–2020 (
p-value > 0.001) and studying hours before the COVID-19 pandemic (
p-value = 0.030). However, no significant difference was observed between Turkish and Jordanian students regarding their GPA for 2020–2021 (
p-value = 0.074) and studying hours after the pandemic (
p-value = 0.525).
Among Turkish students, a significant difference was observed between their GPA for 2019–2020 and 2020–2021 (p-value = 0.004). Moreover, a significant difference was observed between the studying hours before and after the pandemic (p-value = 0.019). On the other hand, among Jordanian students, no significant difference was observed between the GPA for 2019–2020 and 2020–2021 (p-value = 0.100). Moreover, no significant difference was observed between the studying hours before and after the COVID-19 pandemic (p-value = 0.354).
Focus Group Results
The answers obtained from the students who participated in the focus group (n = 12) were summarized thematically as the pros and cons of the online learning during COVID-19. Regarding the pros, students from Jordan stated that online learning provided a more accessible and flexible approach to learning as the students could open the recorded lectures anytime from anywhere. Moreover, some students mentioned that they do not need to wake up early which was more comfortable, thus, they did not face the traffic jam while going to their university. In contrast to this, many cons were mentioned, such as internet issues faced by the students which increased their stress, especially during exams, and not all the teachers were familiar with online learning. Moreover, students mentioned that the exams were not fair enough as online learning increases the copying and cheating possibility among students. Some students also mentioned that they faced some difficulties in communicating with their teachers, and some teachers were responding late to their messages, thus, the students did not have the answers to their questions immediately. In general, the mentioned cons were more than the pros. When students were asked whether they preferred online learning or face-to-face learning, a consensus among the focus group was observed as all of them preferred face-to-face education. Students were asked if the online education affected their grades, 60% stated that they got higher marks and 40% stated that online learning negatively affected their marks. Several approaches were used by the students during the online learning, such as watching YouTube® videos if some of the points in the lectures were not clear or fully understood by them. They also mentioned that some of their studying habits have changed during the COVID-19, as most of them stated that their studying hours were mostly during night-time. Lastly, the students were questioned regarding the short-/long-term impact of online learning, most of the students stated that the impact is generally negative, as some students mentioned that they missed the practical part of the labs, and this may affect their skills and capabilities in the future if they worked in an industrial environment. Some students also expressed concerns that they may have a lower chance of getting a job because the owners of pharmacies, for example, prefer graduates who have received face-to-face education.
The answers obtained from Turkish students indicated the following pros: no time is consumed on transportation, for example, one of the students mentioned that she needs more than an hour and a half to reach her university, no need to buy books as the teachers uploaded the PDF version of the needed books, and the lectures were saved, thus, there was no need to attend the class as the student can watch it anytime through the records. Moreover, the students mentioned that COVID-19 made life slower, thus, there is more time to think about the spiritual side of life, and there is more time for Dua’a. On the other hand, the mentioned cons were that COVID-19 increased laziness, not being able to meet friends which made students less social, for example, one of the students said “I do not want to communicate with people through a screen”, many interruptions during the class, the level of comprehension and understanding of the class was lower, and the possibility of copying and cheating is higher so the exams were not fair. One of the students mentioned that all of her colleagues were getting high marks and to avoid getting low marks she started to copy andcheat to be the same with her peers, she said “The main goal of education became the mark, not the learning”. Most of the students preferred face-to-face learning versus online learning. Furthermore, one of the students stated that the education should be a combination of both approaches, online lectures and face-to-face exams. One of the students mentioned that the university is not just a place for learning, but it also gives other skills such as communication skills with others. With regards to their marks, the students mentioned that at the beginning of the online learning, their marks were high; however, the teachers started to expect students to copy so they increased the difficulty of the questions and that resulted in lowering the students’ marks. Moreover, the teachers reduced the exam time to decrease the possibility of cheating. The most mentioned approach by the students during the online learning was listening to the recordings more than one time, and they also mentioned that the effort on the students became somehow more compared to the face-to-face learning. With regards to their habits, most of them stated that their studying hours were mostly during night-time. The short-term impact of online learning was answered more-or-less positively, as the students mentioned that previously it was mandatory to go to the university, however, during the online learning they were studying with a desire to learn. Additionally, the students mentioned that they were eating more, which led to weight gain. Regarding the long-term impact, the answers varied among the students, some stated that their knowledge would be weaker compared to students who received all their education face-to-face. Some stated that they did not know what the consequence of the online learning might be, and some stated that they were giving online lectures and they would probably benefit from this experience.
4. Discussion
The COVID-19 pandemic affected all aspects of life all over the world, including tertiary education. Providing tertiary education was significantly affected due to the closing of universities as a measure to decrease the spread of the virus [
25,
26,
27]. Online learning was implemented as an alternative to face-to-face education at universities, during the pandemic curfews [
28,
29]. Online learning became the main form of learning, and it was included in the ministries of higher education future plans. This study is the first to evaluate the effect of the online education adopted by universities in both Turkey and Jordan. Results showed that the online education followed in Turkey and Jordan during the current pandemic was successful. Globally, universities moved into adopting online teaching programs for undergraduate and postgraduate teaching to overcome these difficulties [
26]. Assessing the effect of online learning was vital in order to provide information regarding the success of the process and future plans for tertiary education, during and after the COVID-19 pandemic [
30]. Mobile technologies enabled easy access to online learning platforms and facilitated long-distance learning effectiveness [
29]. Many studies reported that online learning could increase student participation, improve the quality of discussions, and foster further online interactions [
29]. Drawbacks to online learning exist, including lack of follow-up by eye contact communication and students’ lack of experience during the practical courses and experiments.
Turkey and Jordan are developed countries, and both have a very strong education system, and a high percentage of their population is students. This highlighted the importance of focusing on this group of the population during the COVID-19 pandemic. Regarding the number of students in both countries; in Turkey, as of December 2020, there were 131 public and 78 foundation (private) universities serving 7.94 million students in different academic programs [
31]. This led policymakers in Turkey to focus on providing high quality online services to serve this large group of students. Turkey has a huge infrastructure, and telecommunication companies have high budgets and investments in their frame, thus, this was reflected in the level of their services and good connection was offered to their customers throughout the country, enhancing the online learning methods and the online learning outcomes. With the growth of technology and the internet, online learning secured a good position in the academic world [
32]. Furthermore, because most of the course materials were available online, the interaction between instructors and students regarding course contents was greatly reduced compared to face-to-face learning [
33]. To improve the quality of online learning outcomes, it was important to improve the quality of network infrastructure, improve the quality of instructional learning provided by the lecturers, and offer credit subsidies for students [
34]. In recent years, faculties and universities in Turkey have been attempting to convert, especially the medical-related fields, into individualized, virtual education by decreasing classic routine lectures, applying more technology for laboratory lessons, encouraging active self-learning and integrating education [
15].
In Jordan, there are around 236,000 university students [
35]. During the last ten years, higher education in Jordan witnessed a significant development in terms of the diversity of educational programs and teaching patterns that control both the quality and quantity of universities and other higher education institutions. Despite limited financial and human resources in Jordan, higher education lies within the main concern of the policymakers. Consequently, the number of public universities has reached 10, in addition to 17 universities that are private, and 51 community colleges. This increase in the numbers of universities was supplemented by a significant upsurge in the number of students enrolled in these universities. In the Middle Eastern region, Jordan’s educational role has become so effective in what has been established about the high value of its educational system, becoming the focus of attention in the region, which was reflected in the 28,000 foreign students studying in Jordan [
36]. As for online learning, a previous study conducted by Alkhalil et al. and published in January 2021 found that students in Jordan are satisfied with the online teaching and learning instituted by their university [
37].
The assessment of online education regarding the practical courses showed significant differences between Turkey and Jordan. The proportion of Jordanian students who expressed ‘Not good’ while evaluating the online courses during COVID-19 was about two times more than that of Turkish students. Hence, the technological evolution that was implemented in Turkey during the previous recent years prior to COVID-19 did have a positive impact on the practical courses delivery in Turkey during the pandemic [
38]. Simulation labs can provide an impactful resolution in delivering practical labs that need to meet specific learning outcomes which circulates around certain skills. These simulation labs can be taught off-campus as well as on-campus adding to its benefits in the era of online learning [
39].
In general, the GPA of Turkish students was significantly higher than the GPA of Jordanian students before the COVID-19 pandemic. Although Turkish students had a higher GPA score, they reported fewer studying hours than Jordanian students. Turkish students’ study in their native language, while Jordanian students’ study via a foreign language (English), which could be behind the longer studying hours needed by the Jordanian students to meet a good GPA.
Regarding the students’ opinion about the effect of online learning on their GPA, around 15% of the Jordanian students reported that their GPA became better in comparison to the previous semester before COVID-19. Such effect was lower on the GPA of students living in Turkey. This significant difference in GPA change reported by Jordanian students can be justified by the possibility of students using their books during exams or due to having more time to spend on studying instead of spending it on public transportation to and from the university.
Because of the complete lockdown in Jordan during the data collection period of this study, this new situation led Jordanian students to follow new habits as to stay awake most of their night hours; as a result of that, their sleeping hours were less than usual. The situation in Turkey was not changed when comparing sleeping hours before and after COVID-19. Partial lockdown in Turkey compared to complete lockdown in Jordan could explain such differences. The total lockdown could have changed the sleep pattern in Jordan more tremendously when compared to the change in sleeping pattern reported in Turkey. Caffeine intake by university students would be expected to be affected during pandemics and curfews. Students involved in this study showed that students from Turkey had less caffeine compared to students from Jordan. This can explain the longer sleeping hours reported by Turkish students compared to Jordanian students.
The smoking status of students and effect of COVID-19 on it was also assessed in this study. Although there was no significant difference between Turkey and Jordan regarding students’ smoking status, it was clear that the percentage of smokers amongst the students living in Jordan was higher than that in Turkey (19.5% vs. 7.9%, respectively). It is not known whether this fact affected the number of COVID-19 cases developed amongst the university students included in this study from both countries. Previous research around this topic did not reach a consensus. A research study conducted by Paleiron et al. (2021) suggested that the smoking status of the participants was associated with a lower risk of developing COVID-19 [
40], whereas Sokolovsky et al. (2021) found no such association [
41].
This study comes with limitations. The fact that there was a difference in the area of knowledge of the students surveyed (60.0% of the Turkish students were studying a humanities-related field while more than 60.0% of the Jordanian students were studying a health-related field) could have affected the outcomes of the study by influencing the students’ responses. The sample size recruited in this study might not be representative of all students in Jordan and Turkey considering the variation found in both countries when it comes to the location of the universities and living status background of the students.
In conclusion, the tertiary education in Turkey and Jordan was affected during the pandemic, however, the learning outcomes for students were shown to be acceptable and the online education followed in both countries was effective. Most likely the increased attention paid to developing online learning and good internet services played a role. More students from Jordan as compared to Turkey believed that the online learning with regards to the practical courses received during the pandemic was not as good as the year before the pandemic. Universities in Jordan need to pay extra attention when it comes to online practical learning; for example, simulation labs can benefit students’ practical skills greatly when learning off campus. Results showed that although the GPA of the students in both countries increased following the pandemic, the studying hours reported by the students decreased in both countries, and that decrease was significant in Turkey, hence, educators in both countries need to reassess the evaluation criteria used in online learning in order for it to reflect more accurately the level of the students and efforts they have put into their studies. Future lines of research need to look into improving the online process for practical courses in both countries and the different evaluation methodologies that can be used in evaluating students’ work and practical skills for distance learning.