Development and validation of a comprehensive tool to study the various elements influencing the utilization of E-learning among undergraduate health professions students

Abstract Background E-learning has emerged as a transformative approach in medical and dental education in India, offering flexibility and accessibility to students. However, there is a lack of a standardized tool to assess the multiple dimensions influencing e-learning utilization among undergradua...

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Main Authors: Archana Prabu Kumar, Prabu Kumar Chokkalingam Mani, Komal Atta, Abirami Omprakash, K. Maheshkumar, Hany Atwa, K. N. Maruthy, Padmavathi R.
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Medical Education
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Online Access:https://doi.org/10.1186/s12909-025-07582-0
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author Archana Prabu Kumar
Prabu Kumar Chokkalingam Mani
Komal Atta
Abirami Omprakash
K. Maheshkumar
Hany Atwa
K. N. Maruthy
Padmavathi R.
author_facet Archana Prabu Kumar
Prabu Kumar Chokkalingam Mani
Komal Atta
Abirami Omprakash
K. Maheshkumar
Hany Atwa
K. N. Maruthy
Padmavathi R.
author_sort Archana Prabu Kumar
collection DOAJ
description Abstract Background E-learning has emerged as a transformative approach in medical and dental education in India, offering flexibility and accessibility to students. However, there is a lack of a standardized tool to assess the multiple dimensions influencing e-learning utilization among undergraduate health profession students. This study aims to develop and validate the Comprehensive Knowledge, Attitude, and Practice Questionnaire (CKAPQ) to examine various factors affecting e-learning utilization among undergraduate medical and dental students. Methods The study employed a cross-sectional validation design using Zhou’s Mixed Methods Model to develop and validate the CKAPQ. The initial questionnaire contained 59 items across eight theoretical factors. Content validity was assessed using the Lawshe method, and the CKAPQ survey was conducted from 2014 to 2017 among medical and dental students at a South Indian tertiary care university. Data were analyzed using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to validate the questionnaire structure and verify the theoretical framework. Model fit was assessed using indices such as Goodness-of-Fit Index (GFI), Adjusted Goodness-of-Fit Index (AGFI), Root Mean Square Error of Approximation (RMSEA), Normed Fit Index (NFI), Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), and Standardized Root Mean Square Residual (SRMR). Construct validity and structural equation modelling (SEM) were assessed. Results A total of 960 students (61.6% females, 38.4% males) participated in the study. Through EFA, eight items were removed based on skewness and kurtosis values, and 35 items were excluded due to factor loadings < 0.5. The Bartlett’s Test of Sphericity was significant (p < 0.001), and the Kaiser-Meyer-Olkin measure (0.733) indicated sampling adequacy. The final model comprised 16 items representing five constructs with factor loadings ranging from 0.557 to 0.834. The model demonstrated good reliability (Cronbach’s α ranging from 0.65 to 0.78) and strong absolute fit indices (GFI = 0.982, AGFI = 0.971, SRMR = 0.063). Construct validity was supported by Composite Reliability (0.729–0.848), Average Variance Extracted (0.516–0.669), and Maximum Shared Variance (0.143–0.304). The SEM model revealed significant correlations between constructs, with PLE and PEI showing strong positive correlation (r = 0.614), while negative correlations were observed between PLE, PEI and other factors. Conclusion The proposed theoretical model had eight factors, while the psychometric properties of the CKAPQ and calculations of fit revealed a five-factor model. The developed CKAPQ provides a new, standardized method to evaluate knowledge, attitudes, and practices related to E-learning among medical and dental students.
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spelling doaj-art-ad60ecb6df86451190df6e4e7e10f9642025-08-20T03:46:07ZengBMCBMC Medical Education1472-69202025-07-0125111910.1186/s12909-025-07582-0Development and validation of a comprehensive tool to study the various elements influencing the utilization of E-learning among undergraduate health professions studentsArchana Prabu Kumar0Prabu Kumar Chokkalingam Mani1Komal Atta2Abirami Omprakash3K. Maheshkumar4Hany Atwa5K. N. Maruthy6Padmavathi R.7Medical Education Department, College of Medicine and Health Sciences (CMHS), Arabian Gulf University (AGU)Department of Pathology, Government HospitalsDepartment of Medical Education, The University of FaisalabadDepartment of Physiology, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute of Higher Education and Research PorurDepartment of Biochemistry and Physiology, Government Yoga and Naturopathy Medical College and HospitalMedical Education Department, College of Medicine and Health Sciences (CMHS), Arabian Gulf University (AGU)Department of Physiology, PES Institute of Medical Sciences and ResearchDepartment of Physiology, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute of Higher Education and Research PorurAbstract Background E-learning has emerged as a transformative approach in medical and dental education in India, offering flexibility and accessibility to students. However, there is a lack of a standardized tool to assess the multiple dimensions influencing e-learning utilization among undergraduate health profession students. This study aims to develop and validate the Comprehensive Knowledge, Attitude, and Practice Questionnaire (CKAPQ) to examine various factors affecting e-learning utilization among undergraduate medical and dental students. Methods The study employed a cross-sectional validation design using Zhou’s Mixed Methods Model to develop and validate the CKAPQ. The initial questionnaire contained 59 items across eight theoretical factors. Content validity was assessed using the Lawshe method, and the CKAPQ survey was conducted from 2014 to 2017 among medical and dental students at a South Indian tertiary care university. Data were analyzed using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to validate the questionnaire structure and verify the theoretical framework. Model fit was assessed using indices such as Goodness-of-Fit Index (GFI), Adjusted Goodness-of-Fit Index (AGFI), Root Mean Square Error of Approximation (RMSEA), Normed Fit Index (NFI), Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), and Standardized Root Mean Square Residual (SRMR). Construct validity and structural equation modelling (SEM) were assessed. Results A total of 960 students (61.6% females, 38.4% males) participated in the study. Through EFA, eight items were removed based on skewness and kurtosis values, and 35 items were excluded due to factor loadings < 0.5. The Bartlett’s Test of Sphericity was significant (p < 0.001), and the Kaiser-Meyer-Olkin measure (0.733) indicated sampling adequacy. The final model comprised 16 items representing five constructs with factor loadings ranging from 0.557 to 0.834. The model demonstrated good reliability (Cronbach’s α ranging from 0.65 to 0.78) and strong absolute fit indices (GFI = 0.982, AGFI = 0.971, SRMR = 0.063). Construct validity was supported by Composite Reliability (0.729–0.848), Average Variance Extracted (0.516–0.669), and Maximum Shared Variance (0.143–0.304). The SEM model revealed significant correlations between constructs, with PLE and PEI showing strong positive correlation (r = 0.614), while negative correlations were observed between PLE, PEI and other factors. Conclusion The proposed theoretical model had eight factors, while the psychometric properties of the CKAPQ and calculations of fit revealed a five-factor model. The developed CKAPQ provides a new, standardized method to evaluate knowledge, attitudes, and practices related to E-learning among medical and dental students.https://doi.org/10.1186/s12909-025-07582-0Distance education and online learningMedia in educationTeaching/learning strategies
spellingShingle Archana Prabu Kumar
Prabu Kumar Chokkalingam Mani
Komal Atta
Abirami Omprakash
K. Maheshkumar
Hany Atwa
K. N. Maruthy
Padmavathi R.
Development and validation of a comprehensive tool to study the various elements influencing the utilization of E-learning among undergraduate health professions students
BMC Medical Education
Distance education and online learning
Media in education
Teaching/learning strategies
title Development and validation of a comprehensive tool to study the various elements influencing the utilization of E-learning among undergraduate health professions students
title_full Development and validation of a comprehensive tool to study the various elements influencing the utilization of E-learning among undergraduate health professions students
title_fullStr Development and validation of a comprehensive tool to study the various elements influencing the utilization of E-learning among undergraduate health professions students
title_full_unstemmed Development and validation of a comprehensive tool to study the various elements influencing the utilization of E-learning among undergraduate health professions students
title_short Development and validation of a comprehensive tool to study the various elements influencing the utilization of E-learning among undergraduate health professions students
title_sort development and validation of a comprehensive tool to study the various elements influencing the utilization of e learning among undergraduate health professions students
topic Distance education and online learning
Media in education
Teaching/learning strategies
url https://doi.org/10.1186/s12909-025-07582-0
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