31.20.44 Impact of Blended Learning Environment on Self-Directed Learning Skill Development Among Post Graduates of Health Professions Education

Original Article


Impact of Different Learning on  Health Professions Education

Impact of Blended Learning Environment on Self-Directed Learning Skill Development Among Post Graduates of Health Professions Education

Saira Waqqar1, Aasma Qaiser2 and Amna Ahmed Noor3


Objective: The study aims to identify impact of blended learning environment on self-directed learning skill development among post graduates of Masters in Health Professions Education.

Study Design: Qualitative Study

Place and Duration of Study: This study was conducted at Riphah International University from September 2019 to February 2020.

Materials and Methods: Semi-structured interviews of all participants were audio recorded and transcribed verbatim. Later manual thematic analysis was performed to get meaning within the data.

Results: Three major themes 1) Self-paced E learning, 2) motivation and satisfaction, 3) project-based teaching and learning were identified from ten sub-themes. The main factors like flexibility and convenience given to them in their learning, structured assessment policy, time management, self- pacing, more access to resources, and ease of communication have a major role to develop self-directed learning skill. Health professions Education is an emergent, interesting master degree program under blended learning environment that offers a great opportunity to be a lifelong learner to those who have completed their bachelor degree under traditional curriculum, in fact, most of the participants were rote learner are were not familiar to integration.

Conclusion: Health Professions Education is an emergent Master degree program with pure blended learning environment, providing platform for health professionals to polish their soft and management capabilities through development of self-directed learning skill. This program enables the students to define and achieve their set goals within specific timeline. Infect, making students self-directed and lifelong learners in their continuing professional education.

Key Words: Blended learning; Health profession education post graduate students; learning effectiveness; Motivation, Self-directed learning.

Citation of article: Waqqar S, Qaiser A, Noor AA. Impact of Blended Learning Environment on Self-Directed Learning Skill Development Among Post Graduates of Health Professions Education. Med Forum 2020;31(10):189-193.




In recent decades, with innovation in technology and digital communications there has been an increasing trend towards blended learning and wholly online educational approach.1



1. Department of Rehabilitation and Allied Health Sciences, Riphah International University, Islamabad.

2. Dental Surgeon, Mohi Ud Din Islamic Medical College Mirpur Azad Kashmir.

3. Department of Medical Education. Mohtarma Benazir Bhutto Shaheed Medical College Mirpur.



Correspondence: Dr. Saira Waqqar, Senior Lecturer in Faculty of Rehabilitation and Allied Health Sciences, Riphah International University, Islamabad.

Contact No: 0333-6176884

Email: Saira.waqar@riphah.edu.pk



Received:    March, 2020

Accepted:    July, 2020

Printed:        October, 2020



In higher education institutes, instead of one-on-one teaching and learning, there has been rising interest towards internet-based methodologies of teaching and learning like blended learning.2 Blended learning has become a popular approach that assist learning.3,4 It is a blend of traditional person to person and online teaching. This has changed student’s way of assessing and expand knowledge, critical thinking and updating skills at workplace.5 In blended learning environment, self-directed learning is thought to be one of the crucial skills that help students in their continuous professional development.1

There has been much debates related to trends and preferences for online teaching and learning in higher educational institutes. Using information and communication technology to enhance students self-directed learning,3 perceptions of self-directed learning and digital technology usage in professional development,1 blended environment and student satisfaction,2 educational strategies associated with problem solving, critical thinking and self-directed learning experiences during training,6enhancing teaching skill through blended learning environment 7and integrating blended learning in higher education.8

Previous studies have shown that high self-directed learning skills are pivotal for effective online learning.9 but there is a mini debate on effect of blended learning environment on development of self-directed learning skills among students of Masters in Health Professions of Education. Usage of these learning technologies combined with traditional person to person learning and its impact on self-directed learning skills of postgraduate students was the main aim of this study.


A qualitative study was carried out from September 2019 to February 2020 in Riphah International University.

Sampling technique: The 9 post graduates who were completed their MHPE and willing to participate in the study were selected through purposive, homogenous sampling technique.

Data collection: All the participants were clarified about research consequences and a written informed consent was obtained from all participants. An interview guide (IG) was prepared and pilot tested, having validated interview questions. The questions in IG were written in full sentences but in reality, their formulation and order were adjusted according to situation during interview. Later, semi structured one-on-one interviews of all participants were conducted using interview guide. Interviews lasted for 60-90 minutes until data saturated. Both male and female postgraduates of MHPE program were included in this study. All interviews were conducted in a safe and comfortable environment.  Notes were also taken during the interview. Data was audio recorded and then transcribed verbatim.

Data Analysis Procedure: Data analysis started early during data collection process. Thematic analysis was employed to generate codes. After reading through the interviews several times and the generated codes, data was categorized to develop themes. Themes were further refined after discussions with all the authors.


Participants (n=09) were post graduates of health professions education. They Belonged to different health care professions (Table-I). They have recently completed their MHPE degree program and shared their experiences how their self-directed learning habit was influenced by this blended learning environment.


Table No.1: Demographics of participants

Participant No

Basic Qualification







































In one on one semi structured interview participants identified a number of factors that proved to be helpful in improvement of their self-directed learning skills.  Three main themes derived after data analysis were 1) Self-paced- E learning, 2) Motivation and satisfaction 3) Project based teaching and learning. Five attributes relating to themes are described in (Table-2). Remaining five are briefly described below:

Theme 1. Self-paced E learning

Use of technology: Innovation in digital technologies brought tremendous change in teaching and learning. Most of the participants indicated that use of digital technologies during this course not only improved their critical thinking skill but also have a great positive impact on their self-directed learning skill.

“I highly appreciate to the Moodle platform that provide opportunity of full time accessibility to the course with its relevant materials to follow and understand it” (participant #6).

Theme 2. Motivation with satisfaction

Reflection: Reflection is an integral part of blended learning, significant tool for engaging students and is helpful in enhancing student’s behavioral, emotional and cognitive processes. Most of the participants were in favor of daily self-reflection activity they did during their 10 days contact session.

“We were bound to write reflection daily, what we learn, about our lectures and daily activities, teaching strategies used and behavior of our instructors and fellows. This enabled me to critically analyze my whole day activities, what I had learn and what are my strength and weaknesses and how I can improve them, infect it was a source of my internal motivation” (P#4)

Theme 3. Project-based teaching and learning

3.1. Use of metacognitive strategies: Metacognition is considered to be a set of learning skills that make students responsive how to evaluate their self and acclimatize progressively with metacognitive skills to become an effective learner. Projects and different learning activities enabled students to use metacognitive strategies.

“I was not familiar with the term metacognition, we were taught about metacognitive strategies but I learn best by interacting with peers who were more advanced than me, I observed their proficient use of a metacognitive skills and try to follow them” (P#5)

“Self-directed learning enabled me to do literature search from authentic sources to find out the answer of particular question that is related to my task. For finalization the task, I take time to review it critically, without the instructor support that sort of thing” (P #9)

3.2. Developing own learning objectives: It was the opinion of participants that during their master’s degree program with blended learning environment they practiced how to write learning objectives. Writing of these specific statements helped us to evaluate our progress and what we are going to achieve at the end of project.

“I think practice of writing own learning objectives means actually you are polishing your self-direction skill. Leaning objectives served as road map towards your goal, so in order to achieve a given task set your goal, write your objective, monitor progress, evaluate and finally you will find results” (P#3)

3.3. Sense of responsibility: Self-directed learning is directly associated with sense of responsibility. In blended learning environment you have a contact session of only ten days, remaining two months before next contact session students have to take the responsibility of their own learning.

“After contact session, our instructors gave us assignments and explained how we have to complete this task with in a given time. These home task created a sense of responsibility and I was bound to manage my time and other activities in order to complete the task in time” (P#6)



Table No.2: Impact of blended learning environment on development of SDL skills




Self-paced E- learning

       Conducive and flexible learning environment

       “For me it was a very conducive and flexible learning environment, more comfortable to learn at my own pace, enabled me to figure out things personally, took initiative to make my own decisions rather than a class where everyone is expected at a same rate” (P#4)

Motivation with satisfaction

       Peer communication



       Constructive and timely feedback

     “As we have interaction with our teachers only during contact session but on Moodle and discussion forum we interact with our fellows and discus and express our views” (p#1)

     “I was a rote learner, but time bound assignments and timely constructive feedback from teachers motivated me, how I have to learn on my own and improve my grades” (P3#)

Project based teaching and learning

       Time management/task management



       Critical thinking process activation


     “The most important aspect of BL environment was time bound assignment; we learn how to manage time and to complete task in a given time” (P#6)

     “While presentations assigned to me during course, searching literature, application of information and to complete task improved my critical thinking skill” (P#2)



SDL: Self-directed learning*





Our study highlights the different views of post graduates on their self-directed learning skills, recently completed their master degree program with blended learning environment. Comparing with the previous studies, 10,1,11 our findings regarding self-directed learning skills development are less or more similar with a little bit of differences. In our study, conducive and flexible environment and time bound assignments and reflection were the main factors that have positive impact on self-directed learning skills of students. While in the previous study, design of working environment, feedback from instructor were effective in terms of improving self-directed learning of students.12

Blended Learning, a recent trend of higher educational institutes that provides an educational environment with various forms of communication by combining face-to-face learning with technologically enhanced online learning so that instruction and learning takes place both in the classroom and online.13 Flexible learning means  increased  focus of students on personalization of learning experiences and utilization of maximum opportunities available during the learning process.14 Majority of participants appreciated the flexibility given to them in their learning and assessment. They noted that blended learning offered convenience, time management, self- pacing, more access to resources, and ease of communication, but few participants still prefer face-to-face teaching.

Behavior, self-efficacy, environment and motivation affect learning process of a learner.15 it was opinion of participant that traditional courses are mostly theoretical and quite boring. My attention and motivation for the course increased as MHPE course provided both theoretical and practice-based applications along with giving us studying environment different from the traditional classroom. Communication and interactions with the peers in class and discussion forum on Moodle, after every assignment positive and constructive feedback from teachers was a source of motivation among post graduates. Writing reflection on daily basis was a part of contact session and it was opinion of participants that reflection on our daily activities was helpful to motivate us for future activities.

Active participation of learner, using active learning strategies can improve the learning process and performance.16 The emergence of numerous computer technologies allows use of multimedia content and multimedia communication for education, and provides learning material anywhere, anytime. Participants described self-directed learning as requisite characteristic, that is, taking the “initiative” to manage one’s own learning. Recognizing personal learning needs, establishing an approach, pursue information and resources to address that learning need. Some participants valued face to face component of this learning program, micro teaching, projects in small group and discussions with peers broadened their knowledge and provide more experience and ideas. Metacognition, an important aspect of human intelligence, higher learning and closely related to critical thinking. Metacognition means awareness, regulation, monitoring and reflection on any learning process that makes a learner an independent learner. Use of metacognitive strategies in completion of a given task /assignments, time management was a crucial component of this blended learning hence develop a sense of responsibility in participants.

Medical education being a vast field, the essential component to achieve the set goals is appropriate time management. A participant shared that after first contact session he could not manage time with frequent assessments. This mismanagement of time led to first-time failure which was shocking for him. Another participant was unable to focus on studies due to house responsibilities and was unable to perform in a better way. Later, time bound assignments with constructive feedback from supervisors create sense of responsibility and hence I improved my grades. Literature also emphasizes on the need to develop skills such as time management to be a life-long learner.17



Health Professions Education is an emergent Master degree program with pure blended learning environment. It is providing flexible and conducive platform for health professionals to polish their soft and management capabilities through development of self-directed learning skill i.e. time management, effective communication, Critical thinking and task planning. Different instructional strategies, micro teaching, small group discussions and time bound assignments, self-paced and E-learning were the identified factors that promoted self-directed learning skill among post graduates of health professions education. This program enables the students to define and achieve their set goals within specific timeline. Infect, making students self-directed and lifelong learners in continuing professional education.

Acknowledgement: We are highly obliged to the institute and the participants who participated in this study.

Author’s Contribution:

Concept & Design of Study:

Saira Waqqar


Aasma Qaiser

Data Analysis:

Amna Ahmed Noor

Revisiting Critically:

Saira Waqqar, Aasma Qaiser

Final Approval of version:

Saira Waqqar

Conflict of Interest: The study has no conflict of interest to declare by any author.


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