https://doi.org/10.15218/ejnm.2023.04 Erbil j. nurs. midwifery, Vol. 6, No. (1), May 2023 Original Article Students’ Attitude Towards Moodle Learning Management System as A Teaching Strategy in Nursing Educations ABSTRACT Moodle is a free e-learning software platform designed to help instructors facil- itate online courses that promote student participation and group work in the crea- tion of course materials. There are many aspects of the Moodle e-learning platform (MEP) that make it useful for educational and learning purposes. Self-directed learn- ing (SDL) is a difficult goal for many profes- sors teaching at the undergraduate level, but MEP can help make it easier if utilized correctly [1].The Moodle e-learning platform is an effective e-learning tool be- cause it permits the instructor to switch things up in the classroom in ways that pique the students' attention and encour- age them to take an active role in the learning process [2].Moodle is a free and open-source online learning management system (LMS). Moodle is an example of an e-learning platform that may be utilized in the classroom. Moodle allows students a lot of freedom to explore on their own, which in turn encourages them to study, Background and objectives: Moodle stand for Modular Object-Oriented Dynamic Learn- ing Environment. It was created in Australia by Martin Dougiamas. Moodle is freely availa- ble as open-source software, and is flexible and easy to modify. The aim of this study was to evaluate attitude of nursing students towards using Moodle as a learning management system in the nursing programs. Methods: A cross-sectional descriptive study was conducted at the College of Nursing in Erbil city-Kurdistan Region-Iraq. The study included 100 nursing and midwifery students. A non-probability-convenience sampling technique was used to enroll 100 nursing students by submitting a questionnaire to assess their perspectives about new teaching methods such as Moodle in their learning process. Results: The vast majority of the study sample was female and third-year stage students. Most of the students were living in the urban area and mostly is unmarried. Most of the students believed that Moodle improved their academic performance in the teaching pro- cess at the College of Nursing. Conclusion: There was believed that Moodle as a teaching strategy in nursing education programs has a pivotal role in attracting nursing students to learn. Keywords: Moodle; Teaching Strategy; Student; Nursing Education. Dlzar Sedeeq Anwer; Department of Nursing, College of Nursing, Hawler Medical University, Erbil, Iraq. (Correspondence: dlzar.anwer@hmu.edu.krd) 28 Copyright ©2022 The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. Received: 03/09/2022 Accepted: 15/01/2023 Published: 30/5/2023 INTRODUCTION mailto:dlzar.anwer@hmu.edu.krd https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2023.04 Erbil j. nurs. midwifery, Vol. 6, No. (1), May 2023 Original Article engage with one another, and build knowledge through collaborative efforts. Integrating learning with Moodle helps stu- dents reach their goals [3].Students' ability to communicate and engage with others is enhanced when Moodle is used in the classroom. There is no disputing the im- portance of learning management systems (LMSs) to nursing education's faculty devel- opment and capacity building. In the event of a corona pandemic shutdown, working from home has shown to be highly useful [4].Since not enough research had been done on Moodle's efficacy as a nursing teaching method, this study was undertak- en. A nurse educator's use of Moodle as a teaching approach in nursing education is essential in the context of a university-level nursing program since it encourages stu- dents to take charge of their own educa- tion.Using Moodle platform at the College of Nursing in Hawler Medical University is widely available for the nursing students as a synchronous and asynchronous methods. The students were taught by professional instructors about how to use Moodle be- cause this learning management system (Moodle) was new teaching method for nursing students. During pandemic in 2020, the students and faculty were able to use the Moodle as a distance learning instead of the classroom learning. It was an effec- tive teaching strategy in the college of nursing during COVID-19.The purpose of this research was to examine nursing and midwifery students' perspectives on utiliz- ing Moodle as an LMS in the curriculum. It also evaluates Moodle's usefulness as a teaching method for students. The Cross-sectional descriptive design was conducted in this study. The Setting of the Study: The study was conducted at the Col- lege of Nursing in Hawler Medical Universi- ty. Students in the stages 3 and 4 were included in this study. Time of the Study: The study was conducted from June 21 to July 26, 2022.Sample Size and Sampling Method: A non-probability-convenience sample (N=100) of students was used in this study since it was easier to collect data and catch samples. Data Collection: Each question included a "agree" or "disagree" answer and a "don't know" alternative. A unique number was assigned to each form submitted by each student. There were two parts to the questionnaire. A maxi- mum of thirty questions were allowed in the questionnaire, with twenty-six about students' feelings toward Moodle and four requesting basic demographic information. In the first section, students' demographic details were gathered, including their gen- der, marital status, state of residence, and academic year. Part Two included student attitudes on Moodle's usefulness as a teaching tool in nursing education based on their experiences. Data Analysis: Infor- mation was analyzed with SPSS version 22 (Statistical Package for the Social Sciences). Descriptive statistics like frequency and percentage were used to examine the data at first. There were three possible replies to the participant's experiences items: 'don't know,' 'agree,' and 'disagree. Ethical Consideration: Participants in the study were made aware of the research's goals before they agreed to take part willingly. Additionally, the respondents were as- sured that their responses would remain anonymous and be utilized just for aca- demic investigation. The responders filled out the questionnaires and handed them in to the researcher. 29 Copyright ©2022 The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. METHODS https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2023.04 Erbil j. nurs. midwifery, Vol. 6, No. (1), May 2023 Original Article them improve their academic perfor- mance.61% of students thought that using Moodle was an interesting method to study, and 66% of students said that they thought utilizing Moodle in a nursing school was a good concept to help them learn. More than half of respondents 53% found the Moodle setup procedure to be simple and straightforward, and nearly as many 48% appreciated being able to ac- cess course materials from anywhere, not just on campus, thanks to Moodle.60% of respondents confirmed that they received timely instructor feedback through Moo- dle, and 43% of respondents said that Moodle improved the ease with which they could complete course activities. As can be seen in Table 1, 89% of the par- ticipants were female. The vast majority of the respondents 74%, were city residents. The majority of the students 60%, were at the third-stage level . Table 2 shows that nearly half of the re- spondents 49%, think Moodle is helpful for their education in a nursing program because of the good effects it has had on their learning. Almost two-thirds of the respondents 65%, said they were comfort- able navigating Moodle. A majority of the attendees 40%, thought they knew enough about Moodle after the course to get started. It was reported by 32 re- spondents 32%, that using Moodle facili- tated more fruitful two-way interactions between students and teachers. In addi- tion, most people who used Moodle were positive about it. 60% of the students have found using Moodle to be a positive expe- rience. Overall, 55% of respondents be- lieved that they could use Moodle without being shown how it works, and 47% of those polled said that Moodle had helped 30 Copyright ©2022 The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. RESULTS Table 1: Socio-demographical of students Socio-demographical characters Frequency No. (%) Gender Female Male 89(89) 11(11) Residence Rural Urban 26(26) 74(74) Marital Status Single Married 91(91) 95(95) Students’ Stage Third Fourth 60(60) 40(40) https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2023.04 Erbil j. nurs. midwifery, Vol. 6, No. (1), May 2023 Original Article 31 Copyright ©2022 The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. Table 2: Students’ perspective about Moodle as a teaching strategy No. Questions Agree No. (%) Disagree No. (%) Do not known No. (%) 1 Moodle enables me to learn more effectively 47 (47) 39(39) 14(14) 2 Moodle helps my academic achievement 44 (44) 41 (41) 15(15) 3 Moodle improves the effectiveness of my learning 42(42) 46(46) 12(12) 4 Moodle facilitates university learning 52(52) 31(31) 17(17) 5 Moodle empowers me to direct my own learning 42(42) 40(40) 18(18) 6 Overall, Moodle is beneficial to my learning 49(49) 31(31) 20(20) 7 I have access to Moodle's material 51(51) 31(31) 18(18) 8 This Moodle site is completely accessible to me 38(38) 36(36) 26(26) 9 I can use Moodle without being informed how it works 55(55) 31(31) 14(14) 10 I can troubleshoot Moodle issues 36(36) 51(51) 13(13) 11 If there are user instructions available, I can utilize Moodle 43(43) 37(37) 20(20) 12 Overall, I can utilize Moodle 65(65) 29(29) 6(6) 13 Moodle is simple for me to learn 57(57) 32(32) 11(11) 14 Moodle materials are simple to obtain 57(57) 27(27) 16(16) 15 The Moodle process is simple and straightforward 53(53) 32(32) 15(15) 16 In general, I think Moodle is quite user-friendly 54 (54) 36(36) 10(10) 17 Moodle makes education enjoyable 43(43) 40(40) 17(17) 18 It is an excellent idea to use Moodle 66(66) 24(24) 10(10) 19 Moodle is an attractive learning platform 61(61) 24(24) 15(15) 20 Overall, I enjoy working with Moodle 38(38) 46(46) 16(16) 21 I feel confident enough to begin using MOODLE with the training I received. 40(40) 38(38) 22(22) 22 With MOODLE, I was able to access all of my college coursework even when I was not physically in class 48(48) 37(37) 15(15) 23 MOODLE makes it easier for me to complete my course activities 43(43) 41(41) 16(16) 24 MOODLE facilitated my communication with the instructor 32(32) 53(53) 15(15) 25 MOODLE helped me to communicate and collaborate with my classmates 28(28) 61(61) 11(11) 26 MOODLE helped me to get prompt feedback from the in- structor 60(60) 28(28) 12(12) https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2023.04 Erbil j. nurs. midwifery, Vol. 6, No. (1), May 2023 Original Article 32 and these results are consistent with those of an Egyptian study showing that undergraduate nursing students have a favorable attitude toward Moodle's ca- pacity to boost their interest in the course [10].Current study results showed that Moodle was used as a feedback platform, which is consistent with the findings of Deliwe (2020), who claimed that Moodle was implemented for many reasons, one of which was as an interim student feed- back system, a platform for student feed- back [11].The present study indicated that 54% of the students thought that Moodle is quite user-friendly, and this result is consistent with a study conducted in Pal- estine it mentioned that their faculty members 73.5% believed that Moodle offers flexibility [12].A study has been conducted in China, it showed that the students had very positive attitudes to- wards Moodle. Most of them acknowl- edged that Moodle helped them to learn medical statistics to a large extent. The study matches with the present study which identify that Moodle makes it easi- er for students 43% to complete their course activities [13]. Most of the nursing and midwifery stu- dents believed that Moodle as a teaching strategy in nursing education programs has an important role in improving stu- dents’ academic performance. In contrast, some of the students blamed their lack of communication with instructors when they used Moodle in the nursing program. It is important for nursing college to im- prove this weakness, such as communica- tion with the students. Limitations of the Study and Recommendations. The current study's most obvious drawback and the impediment is its tiny sample size. More research with a bigger sample size is Copyright ©2022 The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. Performance, happiness, and participation in the classroom are all on the upswing thanks to Moodle. Moodle is being uti- lized more frequently as a platform for adaptive and collaborative learning, as well as for improving online examinations. Rapid growth in Moodle's use is being driven by its ability to improve academic integrity, ethics, and security, as well as to streamline its interface [6]. The majority of students in this analysis 44% reported that using Moodle had a positive impact on their academic achievement. And 42% said that thanks to Moodle, they're able to learn more efficiently. The majority of students 65% in this survey said they were able to use Moodle as a technology, and these results corroborated the positive attitudes students showed toward the use of technology. This study was congruent with one conducted in South Africa. 70% said they were introduced to Moodle for the first time in college, and 68.3% said they had access to a computer. 67% said they were not proficient with Moodle [7]. In addition to a study from Taiwan show- ing that students in the Moodle group re- ported better levels of perceived satisfac- tion with the pediatric nursing course [8], the current study concluded that utilizing Moodle is an appealing way to learn about 61% of students. Findings from this study are inconsistent with those from a descriptive study done in Nigeria and In- donesia, which found that the Learning Management system application (Moodle) was useful for facilitating com- munication and collaboration among us- ers throughout the entire learning process [9]. Only 28% of students in the current study agreed that Moodle had been use- ful for them in these regards. More than half of nursing students in this study found learning with Moodle enjoyable, DISCUSSION CONCLUSIONS https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2023.04 Erbil j. nurs. midwifery, Vol. 6, No. (1), May 2023 Original Article 33 Copyright ©2022 The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. recommended. Another constraint is the geographical region that only includes the College of Nursing-Hawler Medical Univer- sity. The author declared that there is no con- flict of interest to this study. [1] Amandu GM, Muliira JK, Fronda DC. Using Moodle E-learning Platform to Foster Stu- dent Self-directed Learning: Experiences with Utilization of the Software in Under- graduate Nursing Courses in a Middle East- ern University. Procedia - Social and Behav- ioral Sciences. 2013; 93, 677-683. [2] Ishtaiwa F. Faculty Attitudes and Use of Moodle Course Management System as a Supplement to Face-to-Face Instruction: A Jordanian Case Study. Journal of Educational and Psychological Sciences. 2011; 12(1):11- 44. [3] Mostafa MF, Salama H, Elwasefy SA. Intro- ducing Moodle as a New Path for Nursing Education: Students' Perception, Experience and Barriers. American Journal of Nursing Research. 2017; 5(6):243-249. DOI:10.12691/ajnr-5-6-7. [4] Deliwe AP. The Use of Learner Management System (MOODLE) in Promoting Teaching and Learning. Universal Journal of Education- al Research. 2020; 8(12): 8383-8392. DOI: 10.13189/ujer.2020.082644. [5] Sharma M, Arora S. Moodle in Nursing Edu- cation: A Review Article", International Jour- nal of Science and Research (IJSR). 2020; 9 (5):477– 478. [6] Gamage SH, Ayres JR, Behrend MB. A sys- tematic review on trends in using Moodle for teaching and learning. International Journal Science, Technology, Engineering and Math- ematics (STEM) Education. 2022; 9(1): 2-24. doi: 10.1186/s40594-021-00323-x. [7] Buthelezi LI, Van Wyk JM. The use of an online learning management system by post- graduate nursing students at a selected high- er educational institution in KwaZulu-Natal, South Africa. African Journal of Health Pro- fessions Education. 2020; 12(4): 211-213. [8] Chen Y, Chen CJ, Lee M. Effects of a Moo- dle-based E-learning Management System on E-collaborative Learning, Perceived Satisfaction, and Study Achievement among Nursing Students: A Cross-sectional Study. Research Square. 2022; DOI: 10.21203/rs.3.rs-1402422/v1. [9] Taufiqurrochman R, Muslimin I, Rofiki I, Abah JA. Students’ Perceptions on learning management systems of Arabic Learning through blended learning Model. Jurnal Al Bayan: Jurnal Jurusan Pendidikan Bahasa Arab. 2020;12 (1):22-36. 10.24042/ albayan.v12i1.5276. [10] Fadel EA, Elbilgahy AA, Ibrahim IA, Elmashad HA. Undergraduate nursing stu- dents' and lecturers' attitudes towards modular object-oriented dynamic learning environment: A quasi experimental study. American Journal of Nursing. 2019; 7(1):24- 30. [11] Deliwe AP. The Use of Learner Manage- ment System (MOODLE) in promoting teaching and learning. Universal Journal of Educational Research. 2020; 8(12): 8383- 8392. DOI: 10.13189/ujer.2020.082644 [12] Salhab RA. Faculty members' attitudes to- wards using Moodle at Palestine Technical Khadoorie (PTUK). World Journal of Educa- tion.2019;9(2):152-165. doi:10.5430/ wje.v9n2p151 . [13] Luo, L., Cheng, X., Wang, S. Blended learn- ing with Moodle in medical statistics: an assessment of knowledge, attitudes and practices relating to e-learning. Biomedical Central Medical Education.2017;17(170): 2- 8. doi.org/10.1186/s12909-017-1009-x. CONFLICT OF INTEREST REFERENCES https://creativecommons.org/licenses/by-nc-sa/4.0/