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Peer-reviewedCC BY-NC-ND 4.0BMC Nursing

Digital transformation in nursing education: students’ satisfaction, academic self-efficacy, and challenges with interactive e-books

10 affiliations
  1. 1Lecturer of Critical Care Nursing, Adult Health Nursing Department, Faculty of Nursing, Capital University, Cairo, Egypt
  2. 2Clinical Nursing Sciences Department, Al Rayan National College of Health Sciences and Nursing, Al-Madinah Al-Munawarah, Saudi Arabia
  3. 3Lecturer of Nursing Administration, Faculty of Nursing, Capital University, Cairo, Egypt
  4. 4Nursing Administration, Nursing Department, Fakeeh College for Medical Sciences, Jeddah, Saudi Arabia
  5. 5Lecturer of Medical Surgical Nursing, Faculty of Nursing, Capital University, Cairo, Egypt
  6. 6Assistant Professor, Department of Nursing, Faculty of Applied Medical Sciences, King Faisal University, Alhasa, Saudi Arabia
  7. 7Assistant Professor, College of Nursing, Northern Border University, Arar, Saudi Arabia
  8. 8Lecturer of Psychiatric and Mental Health Nursing, Faculty of Nursing, Capital University, Cairo, Egypt
  9. 9Assistant Professor, Nursing Department, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Wadi Addawasir, Saudi Arabia
  10. 10Assistant Professor, Specialized Health Unit, Applied College, King Faisal University, Alhasa, Saudi Arabia

Abstract

Background: With the increasing integration of digital tools in nursing education, interactive e-books have emerged as innovative resources that promote engagement, flexibility, and active learning. However, evidence regarding their effectiveness in enhancing nursing students’ satisfaction and academic self-efficacy, as well as the challenges affecting their use, remains limited.

Aim: This study aimed to assess nursing students’ satisfaction, academic self-efficacy, and perceived challenges related to the use of interactive e-books.

Methods: A mixed-methods design was employed among 500 undergraduate nursing students at Capital University, Egypt. Quantitative data were collected using validated instruments measuring satisfaction and academic self-efficacy. Descriptive statistics and correlation analysis were used to examine relationships between variables, while multiple linear regression analysis was conducted to identify key predictors of both outcomes. In addition, qualitative data were collected using semi-structured questionnaires and analyzed thematically to explore students’ perceived challenges related to the use of interactive e-books.

Results: The majority of students reported high levels of satisfaction (72.2%) and self-efficacy (63%). A strong positive association was observed between satisfaction and self-efficacy. Multiple linear regression analysis identified academic performance (GPA) as a significant predictor of satisfaction (β = 0.185, p < 0.001) and self-efficacy (β = 0.198, p < 0.001). Prior training was also a significant predictor of satisfaction (β = 0.142, p = 0.014) and self-efficacy (β = 0.155, p = 0.005). Age and academic level were additionally significant predictors across both models, whereas gender was not statistically significant (p > 0.05). The regression models explained a moderate proportion of variance in both outcomes, emphasizing the multifactorial nature of satisfaction and self-efficacy in technology-enhanced learning environments. Qualitative findings revealed key barriers, including technical limitations, content navigation difficulties, limited access to devices and internet connectivity, cognitive overload, and insufficient digital literacy.

Conclusion: Interactive e-books can enhance nursing students’ satisfaction and self-efficacy; however, their effectiveness depends on students’ academic preparedness, technological accessibility, and system design. Addressing identified barriers and strengthening digital readiness are essential for optimizing the integration of interactive e-books in nursing education.

Clinical trial number: Not applicable.

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BibTeX
@article{mekdad2026digital,
  title = {{Digital transformation in nursing education: students’ satisfaction, academic self-efficacy, and challenges with interactive e-books}},
  author = {Ahmed Khalaf Mekdad and Mohamed Hashem Kotp and Rasha Mohamed Elauoty and Hasan Ahmed Awad Basyouny and Hossam Ali Ismail and Ahmed Ali Hafez and Alaa Eldin Moustafa Hamed and Mohamed Ahmed Aly and Ahmed shaaban Attia},
  journal = {BMC Nursing},
  year = {2026},
  month = oct,
  doi = {10.1186/s12912-026-05357-6},
  url = {https://doi.org/10.1186/s12912-026-05357-6},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Digital transformation in nursing education: students’ satisfaction, academic self-efficacy, and challenges with interactive e-books
AU  - Ahmed Khalaf Mekdad
AU  - Mohamed Hashem Kotp
AU  - Rasha Mohamed Elauoty
AU  - Hasan Ahmed Awad Basyouny
AU  - Hossam Ali Ismail
AU  - Ahmed Ali Hafez
AU  - Alaa Eldin Moustafa Hamed
AU  - Mohamed Ahmed Aly
AU  - Ahmed shaaban Attia
PY  - 2026
DA  - 2026/10/26
JO  - BMC Nursing
DO  - 10.1186/s12912-026-05357-6
UR  - https://doi.org/10.1186/s12912-026-05357-6
AB  - Background: With the increasing integration of digital tools in nursing education, interactive e-books have emerged as innovative resources that promote engagement, flexibility, and active learning. However, evidence regarding their effectiveness in enhancing nursing students’ satisfaction and academic self-efficacy, as well as the challenges affecting their use, remains limited.  Aim: This study aimed to assess nursing students’ satisfaction, academic self-efficacy, and perceived challenges related to the use of interactive e-books.  Methods: A mixed-methods design was employed among 500 undergraduate nursing students at Capital University, Egypt. Quantitative data were collected using validated instruments measuring satisfaction and academic self-efficacy. Descriptive statistics and correlation analysis were used to examine relationships between variables, while multiple linear regression analysis was conducted to identify key predictors of both outcomes. In addition, qualitative data were collected using semi-structured questionnaires and analyzed thematically to explore students’ perceived challenges related to the use of interactive e-books.  Results: The majority of students reported high levels of satisfaction (72.2%) and self-efficacy (63%). A strong positive association was observed between satisfaction and self-efficacy. Multiple linear regression analysis identified academic performance (GPA) as a significant predictor of satisfaction (β = 0.185, p < 0.001) and self-efficacy (β = 0.198, p < 0.001). Prior training was also a significant predictor of satisfaction (β = 0.142, p = 0.014) and self-efficacy (β = 0.155, p = 0.005). Age and academic level were additionally significant predictors across both models, whereas gender was not statistically significant (p > 0.05). The regression models explained a moderate proportion of variance in both outcomes, emphasizing the multifactorial nature of satisfaction and self-efficacy in technology-enhanced learning environments. Qualitative findings revealed key barriers, including technical limitations, content navigation difficulties, limited access to devices and internet connectivity, cognitive overload, and insufficient digital literacy.  Conclusion: Interactive e-books can enhance nursing students’ satisfaction and self-efficacy; however, their effectiveness depends on students’ academic preparedness, technological accessibility, and system design. Addressing identified barriers and strengthening digital readiness are essential for optimizing the integration of interactive e-books in nursing education.  Clinical trial number: Not applicable.
SN  - 1472-6955
ER  -