
==== Front
J Educ Health Promot
J Educ Health Promot
JEHP
J Edu Health Promot
Journal of Education and Health Promotion
2277-9531
2319-6440
Wolters Kluwer - Medknow India

JEHP-13-168
10.4103/jehp.jehp_71_24
Original Article
Sustaining hybrid teaching as effective pedagogy at higher education institutions: Students’ voices
Hu Zijing
Department of Complementary Medicine, University of Johannesburg, South Africa
Address for correspondence: Dr. Zijing Hu, R7106d, John Orr Building, Doornfontein Campus, University of Johannesburg, 25 Louisa St, Doornfontein, Johannesburg, 2028, South Africa. E-mail: zhu@uj.ac.za
2024
05 7 2024
13 16812 1 2024
27 3 2024
Copyright: © 2024 Journal of Education and Health Promotion
2024
https://creativecommons.org/licenses/by-nc-sa/4.0/ This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
Background:

There is a dire need to ensure higher education institutions employ effective pedagogy in their educational programs. Hybrid teaching has received increased attention in recent decades due to its effectiveness in improving learning outcomes. There is a lack of studies exploring students’ views on hybrid teaching in acupuncture programs in the South African context.

Objectives:

Therefore, this study explored acupuncture students’ views of hybrid teaching in the acupuncture program. The Technological, Pedagogical, and Content Knowledge Model was anchored in this study as a theoretical lens.

Materials and Method:

The author employed a qualitative single case study design within an interpretivist paradigm. A purposive sampling technique was adopted to recruit six participants for this study from an identified public university in South Africa. Participants were interviewed between March 2023 and May 2023. Data were analyzed through thematic analysis.

Results:

The findings of this study highlight positive student views of the hybrid model, emphasizing its benefits in optimizing the teaching and learning process. However, participants also identify barriers such as poor infrastructure and the absence of computer skills. The study underscores the need for substantial investment in technological facilities and faculty development programs to enhance lecturers’ digital pedagogical competencies.

Conclusions:

While offering valuable insights into the specific context studied, limitations include the single-case design and the focus on a particular student cohort. Despite these limitations, the research contributes to the ongoing discourse on effective teaching methodologies in the dynamic landscape of higher education. Recommendations are proposed to address the identified challenges and foster an inclusive and technologically advanced learning environment in South African HEIs.

Acupuncture
higher education
hybrid teaching
medical students
South Africa
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pmcIntroduction

Higher Education Institutions (HEIs) play a critical role in shaping the intellectual and professional development of students in the world of work. Consequently, there is an urgent need for effective teaching in the 21st-century education. The transfer of knowledge, skills, and values from knowledgeable individuals to students is a systematic process that serves as a cornerstone for achieving desired learning outcomes.[1] In response to the evolving landscape of education, the adoption of innovative teaching models has become imperative. This study explores students’ views of the hybrid model of teaching, a pedagogical approach that integrates both online and traditional contact-based learning, in the context of a South African HEI. In this study, the author asked the research question: “How do students experience hybrid teaching in the acupuncture program?”

The value of effective teaching in achieving educational objectives has been widely acknowledged in the literature.[2,3,4] Effective teaching is crucial for guiding students toward responsible and accountable adulthood, with a primary focus on attaining specific learning outcomes.[5] As the educational landscape continues to evolve, the need for innovative teaching methodologies has become evident. The integration of technology in education, particularly the hybrid model, has gained prominence as a means of preparing students for the challenges of the modern workforce.[1,4,6]

This study delves into the insights of effective teaching and the growing importance of the hybrid model in higher education. Drawing on literature, the research explores the principles of effective teaching, including the alignment of curriculum design with future needs, the incorporation of real-life examples, active student engagement, and the use of varied pedagogical approaches.[5] Additionally, the study examines the need for a hybrid model, highlighting its advantages such as flexibility for students, the development of computer skills, and its role in promoting effective learning outcomes.[7,8] Despite the potential benefits, the study also recognizes the challenges associated with the implementation of hybrid teaching, including issues related to infrastructure, computer skills, and the impact of the COVID-19 pandemic on educational practices. The findings of this research aim to contribute valuable insights into the effectiveness of the hybrid model in South African HEIs and provide recommendations for enhancing the quality of teaching in the dynamic educational landscape. As HEIs strive to adapt to the changing educational paradigm, understanding the nuances of effective teaching methodologies becomes imperative for fostering an inclusive and technologically advanced learning environment.

Literature Review

Value of effective teaching

Teaching is the intentional and systematic process of imparting knowledge, skills, and values from one knowledgeable individual to another.[9] It serves as a purposeful intervention with the goal of guiding students toward responsible and accountable adulthood, focusing on achieving specific learning outcomes.[1] Due to the pivotal role of effective teaching in students’ learning, Lumpkin[2] points out the importance of goal-oriented instruction to attain desired learning outcomes.[9]

To gain insights into effective teaching, Hu[10] and Rezaei et al.[11] highlight the necessity of aligning teaching and curriculum design with students’ future needs, including critical thinking, teamwork, and communication skills. It is crucial for students to acquire a profound understanding of concepts within specific programs or fields.[1] Additionally, integrating real-life contextual examples into teaching illustrates the practical application of theories.[12] Addressing misconceptions and challenging student beliefs play essential roles in promoting effective learning.[9] To optimize learning outcomes, employing a variety of pedagogical approaches is vital to cater to diverse learning needs. Encouraging the active engagement of individual students, educators should demonstrate enthusiasm and deliver interesting, enjoyable, and interactive classes.[13] Consistency between aims, concepts, learning activities, assessments, and future student needs should be ensured in curriculum design.[10] Each lesson should be meticulously planned yet adaptable to allow necessary adjustments based on in-class feedback.[14] Assessment methods must align with desired learning outcomes, involving authentic tasks relevant to the discipline or profession.[4,14] Together, these principles form a comprehensive framework for effective teaching strategies.

Need for a hybrid model of teaching to promote effective teaching

Hybrid teaching represents an amalgamation of online and traditional face-to-face learning methods.[7,15] Due to its significance in higher education, Kazu and Yalcn[8] affirm the benefits derived from combining aspects of both online and traditional classroom learning. Studies conducted by Roomy and Althewini,[5] Kadirhan and Korkmaz,[6] and Al-Qatawneh et al.[16] report increased academic success resulting from the incorporation of a hybrid teaching model in educational programs.

Several advantages accompany hybrid learning, leveraging technologies, such as online videos and audio.[7,17] This approach provides students with greater spatial and temporal flexibility, allowing them to learn at their own pace. Online resources, including videos and audio, enable students to revisit content until they feel confident in their understanding.[18] Simultaneously, traditional face-to-face classes offer a crucial opportunity for in-person interaction with lecturers and peers, contributing to the overall quality of education.[19] Hu and Venketsamy[18] and Al-Qatawneh et al.[20] agree with this perspective, highlighting the importance of social interaction in the face-to-face components of hybrid teaching.[21,22]

Moreover, hybrid teaching equips students with essential computer skills relevant to the workforce while pursuing their educational programs.[22,23] It fosters the development of professional qualities like self-motivation, self-responsibility, and discipline.[7] The potential cost savings associated with hybrid models significantly contribute to students’ academic success in HEIs. Alsalhi, et al.[24] and Nagaeva[23] mention that the reduction in financial costs through hybrid teaching encourages effective learning, particularly in regions facing prevalent poverty like the African continent.[25]

Furthermore, the integration of technology in teaching and learning proves instrumental in facilitating emergency remote education.[22,25] Defined as the urgent yet temporary shift to an alternative mode of educational delivery, emergency remote education became crucial during the COVID-19 pandemic to mitigate the risk of infection by maintaining social distancing.[18] The global adoption of online teaching and learning during the pandemic underscores the necessity of incorporating hybrid teaching in 21st-century education within higher education institutions.

Challenges in adopting hybrid teaching at HEIs

In recent decades, there has been a growing global emphasis on the integration of technology in the field of education. However, the issue of ‘digital inequality’ persists as a challenge in HEIs, where many students fail to acquire fundamental computer skills. Paideya[26] articulates that the abrupt shift to Emergency Remote Education (ERE) poses challenges for both academic staff and students. Emergency Remote Education refers to the sudden shift to online teaching due to the pandemic.[27,28] Studies conducted in the United Kingdom, the United States, and Ireland reveal that over half of academic staff had no prior experience with online teaching before the pandemic. In South Africa (SA), most universities primarily rely on face-to-face teaching and have limited exposure to online or virtual learning, contributing to potential challenges during the transition to ERE.[25]

The overwhelming shift to ERE, as noted by Hu[28] and Scott,[29] has led to increased anxiety and uncertainty among students. Aristovnik et al.[30] identify negative student experiences with ERE, citing issues such as a lack of devices, inadequate computer skills, and difficulties maintaining focus during online learning. In African countries, HEIs face barriers such as poor infrastructure and limited resources.[31] Despite efforts to implement online learning programs, many HEIs still predominantly deliver courses in a face-to-face format.[32] The pandemic has necessitated a transformation in education at HEIs globally, impacting both developed and developing countries.[33,34]

Students, particularly those more accustomed to traditional face-to-face lectures, encounter challenges with online teaching and learning.[35] This challenge is particularly acute in African universities due to poor infrastructure and limited resources resulting from high poverty rates.[34] The cultural practice of group study among African students further complicates the shift to online platforms.[36] Hence, there is a pressing need to adapt to this cultural aspect through online platforms. Díez-Palomar et al.[37] reveal a positive relationship between attitudes and academic achievement, emphasizing the importance of fostering positive attitudes towards a hybrid model of teaching and learning.

Theoretical Framework

A theoretical framework plays a crucial role in enabling researchers to formulate testable research questions, ensuring the advancement of knowledge in research inquiry, and guiding the interpretation of valid and reliable findings and conclusions.[38,39] In this study, the selected theoretical framework was the Technological, Pedagogical, and Content Knowledge (TPACK) model, developed by Mishra and Koehler.[40] This selection was driven by the study’s focus on exploring students’ perspectives and experiences in a hybrid teaching model at higher education institutions, delivered with the integration of technologies. The TPACK model enjoys widespread acceptance in the field of education for promoting the effective use of technologies in teaching and learning,[18,41] and the authors believed that employing this model would enhance the study’s findings.

The TPACK model originated from Shulman’s[42] Pedagogical Content Knowledge (PCK) model, with Mishra and Koehler[40] proposing the integration of technological knowledge, pedagogical knowledge, and content knowledge based on the PCK model. This integration of perspectives effectively encourages and advances the use of technologies in education.[41] The TPACK model consists of seven components, namely pedagogical knowledge (PK), technological knowledge (TK), content knowledge (CK), pedagogical content knowledge (PCK), technological content knowledge (TCK), technological pedagogical knowledge (TPK), and technological, pedagogical, and content knowledge (TPCK). Among these, PK, TK, and CK serve as the core components [refer to Figure 1]. The appropriate combination of these core components generates the remaining four types of knowledge: PCK, TCK, TPK, and TPCK.[43] The model positions technology as the third core domain of teacher knowledge alongside content and pedagogy.[43,44]

Figure 1 The TPACK model (Adapted from © 2024 by tpack.org)

Materials and Method

Study design and setting

In this research, the author employed a qualitative case study design to investigate the views and experiences of participants regarding hybrid teaching at an identified HEI in the Gauteng province. This approach was deemed suitable as the study aimed to delve into the lived experiences of hybrid teaching. This rationale is supported by Hu et al.[14] and Venketsamy et al.,[45] who articulate that a qualitative approach provides an opportunity to gain insights into phenomena. The study embraced the interpretivist paradigm, aligning with Yin’s notion that interpretivism facilitates understanding participants’ lived experiences through the researchers’ interpretation.[39] To achieve in-depth insights into the selected phenomenon, a single case study design was employed. The justification for the single case in this study was that the selected case was critical, common, and relevant to the researchers.[35]

The study was conducted at an identified public HEI in the Gauteng province.

Study participants and sampling

A purposive sampling strategy was adopted to recruit participants, following Cohen et al.’s[38] suggestion that those with the best understanding of the phenomenon should be selected. The author specifically chose 3rd- and 4th-year students enrolled in the Bachelor of Health Sciences in Complementary Medicine (BHScCM) program. This decision was based on the fact that these students had experienced both online teaching during the COVID-19 pandemic and hybrid teaching in the post-COVID era, making them ideal participants with in-depth insights into hybrid teaching. Inclusion criteria are as follows: a) They must enroll in the 3rd or 4th year of the BHScCM program; b) they must be above the age of 18; and c) they must voluntarily consent to participate in the study. A research invitation letter was displayed on the notice board at the identified campus from March 2023 to May 2023. Six (6) students expressed willingness to participate, providing their consent by signing the research consent forms [refer to Table 1]. Pseudonyms were utilized during the reporting phase to ensure participant anonymity and confidentiality. The table below depicts the codes assigned to each participant for this purpose.

Table 1 Participants’ information

Participants	Gender	Age	Year of study	
P1-Y3	F	22	3	
P2-Y4	M	24	4	
P3-Y3	M	25	3	
P4-Y3	F	22	3	
P5-Y3	M	21	3	
P6-Y4	F	23	4	

Data collection and tools

Data collection is a process to gather information about the phenomenon to answer research questions.[38,45] In this study, the authors invited participants who responded to the research invitation to participate in semi-structured interviews. The interviews were conducted between March 2023 and May 2023. To ensure the accuracy of the data, all interviews were audio recorded with participants’ consent. Recordings were transcribed immediately after the interviews. All participants had an opportunity to access the transcripts to ensure the accuracy of the data.

Data analysis

In this research, the author analyzed the raw data inductively. The six-step thematic analysis framework proposed by Creswell[46] was followed as t guide during the data analysis. Venketsamy et al.[3] articulate that this approach allows the researchers to identify the important aspects of data. Thematic analysis is a systematic process. Creswell and Poth[46] state that thematic analysis is a process of clarifying similar and dissimilar views in qualitative studies. First, the authors read through the transcripts several times to be familiar with the data (Step 1). In Step 2, initial codes were applied to the data, followed by identifying initial themes (Step 3). In the next steps, both authors reviewed the initial themes (Step 4) and refined the themes (Step 5). In Step 6, the authors used the themes to answer the research question. In this study, trustworthiness was ensured by multiple techniques, including a valid research design, appropriate research methods, detailed records of the study, audit trail, member checking, and auditing by a second coder.

Ethical consideration

This study was approved by a research ethics committee at a public HEI in Gauteng province (Reference: EDU137/21).

Results

Two themes emerged from data analysis, namely a) participants’ views on the hybrid model of teaching and b) barriers to hybrid teaching at HEI. Verbatim quotes were included in this section.

Theme 1: Participants’ views on the hybrid model of teaching

The findings of this study revealed that the hybrid model of teaching was a popular and effective approach to promoting teaching. Participants concurred that the hybrid model of teaching was beneficial since they shared the advantages of both online and contact teaching and learning. They indicated that hybrid teaching optimized the teaching and learning process. To this, P1-Y3 said:

To me, I think the format in which we are taught under this programme is fine. Because we get to do praticals on different topics, and we are also provided with [online] videos so that we can understand the content easily. This programme has not been the easiest one as I started it with online learning and I did not know more about it, but as time goes on now I know and understand how things work.

P2-Y4 indicated: “The teaching was good. Besides the stress of online learning learning, it has been interesting but challenging. Practicals [contact] have been an integral part of learning.”

P3-Y3, P4-Y3 and P6-Y4 all concurred that the current teaching model was effective. P3-Y3 said: “I prefer the same old ways that we were taught; having lecture videos and also attending contact classes and practicals works the best for me.” P4-Y3 added: “I wouldn’t wish to change a thing about how acupuncture is being taught. Having classes and online lectures.” P6-Y4 explained: “Teaching the theoretical part of acupuncture online and the practical part in person is actually the best way for one to learn acupuncture”.

Theme 2: Barriers to hybrid teaching at HEI

Despite most participants sharing positive views on the hybrid model of teaching in the acupuncture program, they also highlighted some barriers to the program. These barriers included poor infrastructure and the absence of computer skills. P2-Y4 mentioned: “Although lecturers try by all means to teach us what we need to know, the poor internet connection is indeed a big issue when I study online.” P4-Y3 articulated that she was not familiar with the online teaching platform. Consequently, she spent much more time familiarising the platform. This was of particular challenge when the university changed its online teaching platform. P5-Y3 believed that he benefited more from contact classes. He pointed out:

For me, it is hard to understand the theory as it is taught online. Because I always have some questions where I need clarity and I end up not getting the chance to ask those questions. But when I do the practicals, it then becomes easier to understand acupuncture, as I get to see, to feel and to understand what I am taught in theory. And I also get a chance to ask questions if I don’t understand and the lecturer is always there to correct me if I am wrong.

Furthermore, P2-Y4 and P6-Y4 both reported that they experienced increased stress on online teaching as they could not communicate with fellow students.

Discussion

Teaching at HEIs is a purposive process to achieve predesigned learning outcomes.[1,4] Therefore, it is of pertinent significance for HEIs to ensure teaching is effective at their institutions.[10,14] The hybrid model of teaching has been introduced to education with the aim of preparing students’ competencies for the world of work. Lumpkin[2] and Venketsamy et al.[3] emphasize the importance of effective teaching. The author thereafter believes there is a need for lecturers to explore effective ways to teach specific programmes in their contexts such as hybrid teaching. This view concurred with Lalima and Dangwal[7] Kazu and Yalcn[8] and who affirm that hybrid teaching shares the benefit of both online and contact teaching and learning. The findings of this study agreed with the literature that the hybrid model of teaching is an effective pedagogy to strengthen learning outcomes, providing it is utilized appropriately according to the TPACK model. According to Mishra and Koehler[40] and Hannanway[43] lecturers are suggested to select the most appropriate approach in teaching specific disciplines to ensure the effectiveness of teaching. The findings of this study revealed that not all pedagogies were effective when taking specific content knowledge into consideration. For instance, this study substantiated that online teaching was effective for delivering theoretical content knowledge, while practical skills were more suitable to be delivered through contact classes.

There has been an expanded popularity of hybrid teaching in recent decades at HEIs as research supports the increased success in delivering educational programmes through hybrid teaching.[5,6] In the author’s opinion, the hybrid model of teaching not only promotes students’ learning but also improves their computer skills. The reason cited is that hybrid teaching encourages students to acquire more comprehensive computer skills to be competent in studying online. This view is in agreement with Barker[22] and Nagaeva[23] who contend that hybrid teaching at HEIs prepares students’ computer skills in the working world. In addition, hybrid teaching not only provides students with crucial computer skills applicable to the workforce during their academic pursuits,[22,23] but also cultivates the growth of professional attributes such as self-motivation, self-responsibility, and discipline.[7] In a similar vein, scholars, such as Roomy and Althewini,[5] Kadirhan and Korkmaz[6] and Al-Qatawneh et al.,[16] are of the view that hybrid teaching promotes students’ success. They believe hybrid teaching shares the advantages of both online teaching and face-to-face teaching.[15]

The findings of this study also concurred that students benefited from online teaching because they would need to be familiar with the necessary digital skills for the online platform. This study shares a similar view with Rao[19] who reports that hybrid teaching offers an opportunity for students to interact with lecturers and fellow students which further assists in relieving their stress in learning. The author believes that the opportunity to interact with fellow students is of profound significance among African students. Because literature reveals that African students prefer to study in groups.[28,32]

This study revealed that the disadvantage of infrastructure negatively substantially influenced the implementation of hybrid teaching in South African HEIs. This finding aligns with research in other regions that report that poor infrastructure is still a critical matter in African counties where poverty is still prevalent.[20,24] There is a dire need to improve infrastructure to ensure the effective implementation of hybrid teaching at HEIs. To facilitate the successful integration of the hybrid model, HEIs should initiate comprehensive faculty development programs. These programs should equip lecturers with the necessary skills and knowledge to adeptly navigate and utilize technology in teaching. Workshops, training sessions, and continuous professional development opportunities can contribute to enhancing the digital pedagogical competencies of lecturers.[15,18]

Conclusion

The study reveals the pivotal role of effective teaching in HEIs and advocates for the adoption of the hybrid model as a means to enhance students’ competencies for the workforce. Drawing on insights from scholars such as Lumpkin,[2] Venketsamy et al.,[3] and Kazu and Yalcn,[8] the research asserts that hybrid teaching, incorporating both online and contact methods, is a potent pedagogical approach. The study aligns with the broader literature, affirming that the hybrid model, when employed judiciously according to the TPACK model, proves effective in strengthening learning outcomes.[10]

Furthermore, the research agrees with the World Health Organization (WHO)[47] emphasises the nuanced nature of selecting pedagogies based on the specific content knowledge being taught. Online teaching is found to be efficacious for theoretical content, while practical skills are better suited for delivery through contact classes. The findings resonate with the growing popularity of hybrid teaching in HEIs globally, supported by research.[5,6] Importantly, the study posits that the hybrid approach not only enhances learning but also cultivates essential computer skills among students.[18,23]

However, the research sheds light on a significant challenge, namely, the adverse impact of inadequate infrastructure on the implementation of hybrid teaching in South African HEIs. This observation, consistent with broader reports on infrastructure challenges in African countries, underscores the urgent need for infrastructure improvement to ensure the effective implementation of hybrid teaching.[24,28] As the study concludes, addressing these infrastructure limitations is crucial for realising the full potential of hybrid teaching and fostering an inclusive educational environment in South African higher education.

Recommendations

To pave the way for a more inclusive, technologically advanced, and effective educational system that aligns with the evolving demands of the 21st-century workforce, the author proposes the following recommendations to promote teaching at South African HEIs based on the findings and discussion of this study,

Recognising the significant impact of poor infrastructure on the implementation of hybrid teaching, there is a critical need for substantial investment in upgrading technological facilities and ensuring reliable internet connectivity across South African HEIs. This investment should focus on creating a conducive digital learning environment for both students and educators

Student Support Services: Recognising that hybrid teaching may place different demands on students, HEIs should strengthen support services to address potential challenges. This includes providing resources for developing digital literacy skills, creating a helpline for technical issues, and offering counseling services to alleviate any stress associated with the hybrid learning experience.

Acknowledge the potential financial burden associated with online learning, such as the need for personal computers and reliable internet access. Consider implementing financial support programs or subsidies to ensure that all students have equitable access to the resources required for successful participation in hybrid teaching.

Limitations of the study

Despite this study provides a valuable foundation for future research endeavors exploring the intricacies of hybrid teaching in diverse educational contexts and settings, this study was limited to explore students’ views and experiences from one HEI. therefore, the findings of this study lacked comparison. The findings also may not be fully representative of the diverse contexts and challenges faced by other South African HEIs. The reason was that the identified HEI was the only university that offered acupuncture programmes in SA. Future studies can be conducted at international HEIs. Despite the author adhering to a rigorous research process, the interpretivist paradigm’s subjective analysis is acknowledged as a potential limitation. Future research can be conducted using different approaches, such as quantitative or mix methods approaches.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

Acknowledgement

The author would like to express their sincere thanks to the Department of Complementary Medicine, at the University of Johannesburg, for allowing him to conduct this study. The author also would also like to express his sincere thanks to Prof Roy Venketsamy from the University of KwaZulu-Natal for critical advice on this study.
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