Strengthening Statistics Education for Bachelor-Level Nursing Students in Open and Distance Learning: Insights from an Applied Healthcare Curriculum

Abstract

Statistics plays an important role in nursing education as it supports clinical judgement, patient assessment, and the interpretation of healthcare findings. Many nursing undergraduates find this subject difficult, especially in Open and Distance Learning (ODL), where academic commitments must be managed together with shift duties and personal responsibilities. This study explores learning behaviour, performance patterns, and topic-level mastery among more than 300 nursing students enrolled in an online statistics course built around healthcare examples. The course uses e-lessons, a digital flipbook, guided discussions, online quizzes, and a final examination. Results show that learners perform well in descriptive topics that use common patient data but face difficulty with inferential topics such as sampling, probability, confidence intervals, and hypothesis testing. Engagement peaks were recorded before assessments, showing that many students study close to deadlines. The study outlines suggestions for improving support, such as structured scaffolding, healthcare-based examples, and early alerts for students who require additional help.