Influence of learning flow and distance e-learning satisfaction on learning outcomes and the moderated mediation effect of social-evaluative anxiety in nursing college students during the COVID-19 pandemic: A cross-sectional study

Aim: The purpose of this study was to examine the potential mechanism underlying the association between learning flow and learning outcomes in nursing students in South Korea during the pandemic. In particular, we examined the mediation effect of distance e-learning satisfaction moderated by social-evaluative anxiety related to COVID-19 on the relationship between learning flow and learning outcomes. Background: Despite the COVID-19 pandemic, the education of nursing students has continued by shifting the manner of delivering their education. Distance e-learning is being widely used under the strong social distancing policies currently in place and many educators are struggling to enhance the efficiency of this distance e learning. Methods: A cross-sectional study was conducted among 310 nursing students attending two colleges in South Korea. Data were collected from December 2-15 in 2020 by using an online survey. Results: As a result, an association was observed between learning flow and learning outcomes and distance e learning satisfaction mediated this association. Importantly, social-evaluative anxiety caused by COVID-19 moderated the mediation effect of distance e-learning satisfaction. Students' anxiety related to COVID-19 played a negative role in the distance e-learning mechanism for nursing students. Conclusions: It is thus necessary for educators and staff in nursing schools to exert effort to reduce students' COVID-19-related anxiety to enhance the outcomes of distance e-learning in nursing students.