Interpersonal communication

Communication is the transfer of information from one person or group to another person or group, and it is a process for exchanging thoughts, knowledge, and information in a way that realizes the goal or intention in the most suitable possible way [2]. In the most conventional conceptualization, communication is the creation of significant messages that are sent or received from one person to another or between people or groups [4].

Ghazi Saidi et al.(2021) introduced the fundamental teaching characteristics based on the student’s perception. Accordingly, there were five characteristics: careful attention, respect, motivation, giving feedback, and providing lectures. According to their findings, the students’ interpersonal relationships were essential [7]. Interaction can include the interaction of the instructor with the learner, the learners interacting with each other, and the learner with the content [8].

Learner-content interaction is the capability to access and interact with information/content [9]. Interaction with students is one of the most important responsibilities of teachers, both in traditional curriculum and in online courses. The ease of communication influences the interaction between the instructor and the student, the degree of students’ comfort in raising questions and expressing their ideas, and how to access the instructor and respond to the problems related to information [6]. Instructor-learner communication refers to establishing a comprehensive connection with instructors and receiving feedback from them. Interpersonal communication between the students and the instructors mainly emerges in the class during lectures. When the teacher gives a lecture and the students listen, sending and receiving messages occur, resulting in sufficient communication. Effective communication is undoubtedly dependent not only on messages but also on specific characteristics in which interpersonal communication can be effective [9]. Learner-learner interaction includes the interaction of learners with each other and the creation of a learning community. Moore highlights three types of interaction, and his transactional distance theory is derived from these three types of interaction [10]. This article addresses the latter two kinds of interaction in e-Learning.

E-Learning

Learning delivered via information and communication technologies is usually regarded as e-learning [11]. E-learning is sometimes referred to as online learning, web-based learning, computerized learning, computerized teaching, and other equivalent words [12]. The concept of e-learning is very wide. It was forged in the late 90s as a technologically enriched learning instrument via the Internet. Currently, it catches a wide range of electronic media like the Internet, Intranets, and Extranets to make the learning procedure more adaptable. Because of the flexible character of e-learning, it has more demand and requirements among the people of the world than ever before [13].

Compared to traditional settings, e-learning is more self-pace [14]. The findings of Mastour et al. in Iran revealed that students’ learning results were more significantly pronounced e-teaching than in the traditional in-person teaching. They concluded that e-learning could be relished as a successful mode of medical teaching, and that it might be utilized as an alternative educational method [15]. Among the advantages of e-learning, one can mention the following:teaching regardless of time and place, cost-effectiveness, no need for physical presence, the existence of various choices, time-saving, and the development of cooperative learning types [16].

Despite growing evidence that e-learning is as efficacious as traditional methods(Maulana et al., 2023), it arrives with challenges. It was determined in the study of Ahmed et al. 2023 that the challenges encountered by students were a poor internet connection and a lack of interest and desire [12]. The need for complex technology, reduction of social interactions, unstable internet connection, inability to understand students’ facial expressions, and the impossibility of performing practical and laboratory courses are among the weaknesses of distance education [16].

Quality of interpersonal interaction in E-learning

It is specifically critical to understand communication processes in online communities [17], and similar to the goals of face-to-face communication, the goal of online interaction is exchanging information, being heard, and being understood [2]. Moreover, online interactions are one of the basic elements of distance learning, and the use of effective online communication models is very important for empowering distance education learners and for preventing negative experiences such as isolation and loneliness during the course of learning [4]. Online communication enables students to use messages, images, audios, and videos of asynchronous or synchronous interaction systems. Asynchronous communication does not happen in real-time. On the contrary, simultaneous communication takes place in real time and is facilitated by learning management systems (LMS) [4].

In e-learning, as in many other fully online courses, researchers are concerned about challenges that may hinder student learning, including the lack of human interaction in virtual learning. In particular, learning in a virtual learning environment is especially significant due to the physical separation between students and instructors [18]. Physical separation innately causes a psychological and communication gap between the instructor and the learner, and therefore, it might lead to misinterpretation between the teacher and the learners [19].

In two studies, they mentioned the challenges raised in relation to online learning. The challenges included the instructor’s inability to teach the material virtually, not receiving appropriate feedback from students, lack of academic coherence such as the lack of discipline and the possibility of student cheating, doubts about the accuracy and validity of information, concerns about network security and about the privacy of users. Moreover, one might add other challenges and/or requirements: The need for a proper foundation for the proper use of virtual networks and the existence of a strict monitoring system to check and organize the information available in virtual networks [20, 21]. An online survey found that students in online classes face many problems, such as decreased motivation and comprehension, significantly decreased communication between them and the teachers, and isolation cases [2]. This is specifically true for Iran’s higher education since there are prominent challenges related to e-learning in this country in terms of interactions. One study enumerated the main challenges in terms of educational, organizational, ethical, technical, supportive and managerial aspects, and particularly, in terms of evaluation and communication [22]. Sason et al. (2022) reported that during the COVID-19 pandemic, students insisted that they needed to interact with their teachers. From the learners’ perspective, the most common form of interaction was e-mail-mediated educational Interaction. The minor form of interaction was social intimacy. In their qualitative study, Goudarzi et al. (2023) introduced the category called the challenges of the teaching-learning process [16].

Many studies have confirmed the relationship between learners’ engagement and interpersonal interactions [23–25]. Other studies have also emphasized learner-teacher and learner-learner interactions in academic achievement, learning, and satisfaction [24, 25].

The quality of interpersonal interactions is a neglected link in e-learning. Hunter and Ross (2019) study confirmed a positive linear relationship between interactions for each student and the quality perceived by a student in a course. Their study showed that increasing interaction alone could improve students’ experiences and perceptions of quality [8]. The experiences of the respondents of another study indicated the importance of both quality and quantity of interactions in online learning [10]. To our knowledge, therefore, no study has focused on the quality of interpersonal interactions in e-learning.

Educators often seek to replicate the dialogue that is easily achievable in their F2F courses in the online setting by utilizing discussion forums and similar techniques. However, educators have not come to consensus concerning the best interpersonal interaction strategies for an effective student learning / satisfaction. Teachers are frequently pressured to improve the quality of their online courses. However, they have to familiarize themselves with different strategies to encourage students to interact. In other cases, college teachers have been teaching in an F2F environment for years. They are being asked to convert their courses into an online format without pedagogical and technical support [1, 26].

Additionally, many studies on interaction in the online environment do not consider the qualitative aspects of interaction, and they only measure the number of interactions, which typically occurs through such methods as measuring discussion forum posts or course updates [1, 26]. Social and instructional interactions among students and student-instructors are common elements of an F2F classroom. In the F2F classroom, many interactions happen spontaneously. F2F learning provides many opportunities for informal learning where interaction is not planned. In the online environment, this informal learning will take place if students are given the opportunity and appropriate tools to interact with their peers and instructors. For this reason, quality instructional and social interaction opportunities in online environments need to be deliberately designed into the courses [1, 27].

Unfortunately, few studies deal with the quality of interpersonal interactions. In most studies, the experiences of learners have been considered in terms of e-learning effectiveness [28, 29], and some studies have placed emphasis on the learners’ perspective on e-learning challenges [22]. To our knowledge, no study focuses on background and contextual distinctions of learners when reflecting on the quality of interpersonal interactions. For this reason, the present study tries to explain students’ experiences of the quality of interpersonal interactions in e-learning.

Design

This study was conducted from November 2021 to October 2022. The qualitative descriptive design via conventional content analysis was used to explore students’ experiences of interpersonal interaction quality in e-learning. Content analysis is a technique for creating replicable and reasonable abstractions from texts or other significant topics to the contexts of their use [30]. This type of design is usually appropriate when the existing theory or research literature about a phenomenon needs to be revised. Researchers do not use predetermined categories. Instead, it allows categories and category labels to flow from the data [31].

Participants and data collection

The participants were recruited from three medical science universities in Iran. Students of Tehran University of Medical Sciences (TUMS) and Shahid Beheshti Universities of Medical Sciences (SBMS)were selected from two virtual faculties. A group of students were from the Tehran University of Medical Sciences Virtual School. Tehran Virtual School was established for the first time in 2012. It takes students with master’s degrees in e-learning in Medical Sciences, Educational Technology and doctoral degrees in e-Learning by the blended method. Faculty of Medical Education and Learning Technologies of Shahid Beheshti University of Medical Sciences has been taking Medical Education and e-Learning students since 2013. Students study in a blended learning. The Lorestan University of Medical Sciences students were from various disciplines of Medical Sciences who had online learning experience during the COVID-19 era.

Deep and semi-structured interviews were conducted with 16 Persian-speaking students. The primary criteria for including the participants were willingness to participate in research, share experiences, and experience with online teaching for at least one academic semester. The participants were selected by purposeful and maximum variation in gender, age, marital status, semester, educational level, and field of study.

The first participant was a faculty member who was studying as a student in e-learning in Medical Sciences and as a teacher and manager during the COVID-19 era. The participant had the experience of online teaching and addressing problems related to e-learning. In the same way, based on each interview and the obtained data, the next participant to be interviewed was selected.

Before data collection, the participants received a phone illustration of the project. Informed consent was sent the day before the interview, online or in person, and after obtaining informed consent, the participants were interviewed.

The data were collected through semi-structured, in-depth, F2F, or online interviews. Semi-structured interviews, primarily used in health care, include several key questions that help define the research area. In semi-structured interviews, the interviewer utilizes open-ended questions “to debate some subjects in more detail.” By open-ended questions, the interviewer gathers corresponding data from the interviewee(s) with personal ideas [32].

Firstly, the interview guide was compiled based on a literature review and previous experience talking to experts. The order of questions was different for all participants. As the interviews continued and new aspects of the interviewees’ experiences emerged, questions were modified, and other items were added. An interview guide was used (Table 1).

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Table 1. Interview guide.

https://doi.org/10.1371/journal.pone.0298079.t001

The first interview was treated as a pilot interview to confirm that the interview questions were relevant and appropriate for the purpose. The interview lasted 20 to 60 minutes(40 minutes on average). Interviews were recorded through a digital recorder and conducted by one of the researchers (corresponding author) with adequate qualitative research experience. The interview continued until data saturation. Data saturation is reached when the interviewer concludes that no new themes or explanations emerge from the next interviews.

Data analysis

One of the researchers (the corresponding researcher) performed the interviews and manually transcribed the audio recordings. The interviews were analyzed in the manifest form, the meaning of the participants’ descriptions of their experiences, and the latent form, the underlying meanings of the participants’ expressions. Analysis was accomplished simultaneously with data collection and using Graneheim and Lundman (2004) (33)with the following stages:

1. Immediate transcription of interviews
2. Listening to them to obtain a general perception
3. Identification of significant components and initial codes(the label of a meaning unit)
4. Category of similar initial codes in more comprehensive categories (creating categories)

Immediately after the interview, the text of the interview was transcribed, then typed and reread several times so that the researcher could get a general sense of the interview. Then, the rereading of the interviews was continued to determine the meaningful parts. We assume a meaning unit as words, sentences, or paragraphs, including dimensions about each other via their content and context. The condensed meaning units were outlined and labeled by a code. Afterward, the codes were organized using a constant comparison method, recognizing differences and similarities and identifying subcategories. Finally, the findings were compared, and categories and themes were identified.

Trustworthiness

The results should be as authentic as possible, and each study must be assessed regarding the procedures used to create the finding [33]. The Lincoln and Guba criteria, including credibility, dependability, transferability, and confirmability, were used to increase the trustworthiness of the findings. To increase credibility, we choose participants with various experiences of the phenomenon under study, with various genders and ages, educational levels, marital statuses, member checking, and fields of study. The long-term engagement of the researcher (12 months) was also considered. In order to determine dependability, the research team participated in the study process, and the findings were presented to several external observers to review the data analysis process. A clear description of the student’s culture, context, and characteristics and the data collection and analysis process were provided to increase data transferability. The confirmability was accomplished by bracketing, reporting, and documenting the study phases and decisions accurately so that other researchers could track it if preferred and the audit trail could be conducted on analysis.

Ethics approval and consent to participate

This research was done under the Declaration of Helsinki. The ethics code was obtained from the Deputy for Research and Technology of Tehran University of Medical Sciences (IR.TUMS.MEDICINE.REC.1400.686). After providing explanations about the study’s objectives, written informed consent was obtained from all participants. One of the crucial challenges of electronic and online interviews is ethical considerations and getting consent to participate. For this purpose, the consent is sent one day before the interview through email or social networks for participation so that they can read it. The interview is done after obtaining the consent, signing it, and sending the consent form to the researcher.

Theme 1. Teaching and learning factors

Learners’ experiences showed that different aspects of teaching and learning, including instructor characteristics, learners, content, and subject matter, can be practical in interpersonal communication in e-learning.

Most of the students highlighted creating a positive and motivational environment for learning. A friendly atmosphere with trust, reducing tension and anxiety, a comfortable and dynamic environment without discrimination and prejudice, and being an energetic teacher were among the characteristics that the students noticed. The teacher’s pedagogical skills, such as academic capability, a good presentation technique, ability to class management, making an environment for active participation, improving learners’ engagement, paying attention to the learning style of the learners, and getting feedback from the students were also a critical issue in the interaction between the teacher and the learners. Also, the learners stressed having charisma and the essential knowledge and skills in software and applicable instructional design.

If the teacher leaves the student-teacher relationship in the classroom and can be comfortable, I think this is the best interaction to let this student-teacher relationship turn into a friendship" (P.10).

The atmosphere of the class was much more sincere. We did not feel anxious and worried in that class, and I think the interaction was effortless” (P.2).

A teacher needs to manage a class well ” (P.10).

In online teaching, teachers use different communication tools ” (P.6).

All participants emphasized the importance of receiving positive feedback based on principles, transparency, and respect, aiming to improve performance.

” Now that I have entered the learning management systems (LMS) in my sixth semester, some of my assignments related to the previous semesters have no feedback, even though it has been a long time, and I have no hope anymore ” (P6).

” Feedback should be respectful ” (p16).

” The teacher’s feedback method is critical. How clear it is, for example, some professors write that you said no wrong ” (p9).

Discussion forums are asynchronous communication tools widely used in learning management systems that require the teacher’s active participation. According to students, teachers should engage students with these discussion forums and follow up permanently, not temporarily. Some learners emphasized the help of learners in managing the discussions and encouraging students to give fair criticism.

” Unfortunately, there were few chat rooms with few interactions. It was because the teacher’s presence was less ” (P6).

” Forums are excellent environments. It can be said that the most place where we could understand students’ engagement with virtual education was in these forums ” (P4).

” The teacher can get help from other people to manage the discussion forum ” (P15).

” What I think is very effective in the interaction is that students must comment on each other’s comments in the discussion forum. Criticize completely respectfully and morally ” (p8).

Based on students’ experiences, their age, social status, and other background variables influenced their interpersonal interactions in e-learning. Also, soft or non-technical skills such as time management, teamwork, self-regulation, communication skills, and following the rules were reported as necessary from the student’s perspectives. The majority of informants emphasized the number of learners in interpersonal communication. Some participants remarked on the knowledge and skills of learners about ICT.

” A very young person cannot establish a relationship with someone far from him in age. As a rule, there cannot be much empathy between these two people ” (P.5).

” In groups, younger people or peers communicate better with each other ” (P.13).

” In a virtual lesson or course, it is necessary that a person has some background or metacognitive skills ” (P.4).

” The learner must strengthen these skills in herself/himself, such as time management, self-regulation, or metacognition skills; these can help her/him succeed in interaction ” (P.4).

The majority of informants emphasized the standards of developing electronic content. They said that the teachers in multimedia need to follow the principles of voicing and reading from the slides in a monotonous tone. This issue needs better interaction between the teacher and the students. Some teachers even read from the text and do not feel like they are in the classroom as students.

” Sometimes, some lessons were essential, but our teacher spoke monotonously in multimedia. He either reads the text from that slide or lets someone else read it. You wanted to listen to your teacher’s voice, but the voice was someone else’s. You realized that the speaker of the text did not establish a connection with the subject and only read from it ” (P7)

” Some teachers have only one voice in the audio files they upload. As if they are uploading a subject and reading it. You feel that it is not a classroom environment ” (P3).

Participants emphasized logical sequence and coherency between materials.

” Teachers who go step by step are better than those who confuse many topics, and there is no connection between the topics. Teachers with continuity between their materials and go step by step are good ” (P9).

In addition, the participants mentioned the applicability of the topic and their previous familiarity with it. In their opinion, this topic significantly impacted their relationship with the teacher.

” The student’s degree of interest in the lesson is significant, that is, to feel how necessary and practical the lesson is ” (P5).

” If the students had some background information about the subject the professor was teaching, their participation would be good ” (P6).

Theme 2: Features of the platforms

This category consists of asynchronous platforms, synchronous platforms, and social networks. Online learning can be organized into synchronous and asynchronous online courses. Asynchronous online learning does not occur in real-time but in the learner’s program. It is on the idea of constructivist theory, a learner-centered approach that highlights the importance of peer-to-peer interactions. This approach incorporates self-study with asynchronous interactions to demand learning; it can also be applied to facilitate learning in traditional on-campus or traditional, distance, and continuing education. However, synchronous online learning occurs in real-time.

Some participants argued that the best platforms for asynchronous communication, stressing LMS, support Persian font (the common language of Iran). It is user-friendly, and it is possible to have permanent access to the content and track its general performance and advancement. It also has minimal technical issues.

” LMS must also be user-friendly ” (P13).

” In the LMS we had, we had problems sending our assignments. Sometimes, the assignments went one day, and one day they did not; server and font problems were very difficult ” (P13).

” In LMS, students’ activities and interactions can be observed, and their progress can be tracked ” (P4).

Synchronous learning occurs in real-time. Regarding the synchronous platforms, some participants emphasized the necessity of screen sharing. Some participants expressed concern about frequent outages due to poor internet connection and communication interference. On the contrary, they mentioned the possibility of grouping learners in small classes as an opportunity for some synchronous platforms.

” Adobe Connect was perfect, and it was possible to use all kinds of screens that supported the interaction of students with the teacher during teaching ” (P13).

” The problem was the audio and image access; the sound was cut off and connected ” (P3).

” I remember a good experience in the class of one of my teachers. The teacher came and formed several virtual rooms of three people and divided the students between the rooms, and each group had to discuss with each other. The teacher also entered the rooms and supervised ” (P11).

The interesting subject that the participants highlighted was the opportunity of hearing the voice and seeing the image and body language of the teacher.

” Establishing emotional interaction happens only by hearing the teacher’s voice and seeing the teacher’s face ” (P5).

” Seeing the teacher’s face has a significant impact. Because you see the mimicry of his face, you see the movements created on his face and communicate. Regardless, you understand the message better ” (P7).

Designing proper assignments was also vital, and many participants noted it.

” Homework should be something the student feels can be done for his benefit. Moreover, the assignments should be personalized ” (p8).

” Students usually do their studies alone and do not interact with other students until they have to because of group activities ” (p4).

Social media was created as a platform to share information. In this study, students emphasized their essential role and the need to strengthen social networks to improve interpersonal interactions in e-learning. They believed neural networks are a strong tool for reporting and sharing information.

” The messenger network provides the possibility of more interaction between the learners. According to the nature of the network, because it is much more accessible and manageable, it is possible to exchange messages faster in social networks ” (p5).

” Social networks facilitate interaction. I think it was easier to interact through social networks ” (p6).

Theme 3: Systemic factors

This category consists of learner support and extracurricular activities.

Support is one of the critical elements of success for online students, which in the present study was also mentioned by students as a critical element to strengthen interpersonal communication.

One of the learners’ expectations was educational support. Considering the registration and the nature of work and administrative affairs, which were all remote, they expected more guidance and support from the educational staff.

” The presence of the virtual education staff was weak. For example, maybe the education staff is only guided in choosing a unit ” (P2).

Technical support was another form of support mentioned by participants. According to students, they should receive sufficient technical support for synchronous and asynchronous learning platforms.

” When LMS is used, the necessary support must be comprehensive ” (p13).

” Even if they sell software, they support it 24 hours daily. Now, I am a poor student; sometimes I get confused, and I am looking for someone to guide me ” (P10)

Also, Some participants remarked that extracurricular activities are necessary to strengthen interpersonal communication. According to the students, extracurricular activities will stimulate interaction.

” Scientific activities that stimulate interaction outside the classroom ” (P6).

” One of the solutions is to create a space for them to interact outside the academic space, for example, an intellectual game, a simulation, or a game. Now, it can have an educational aspect, like gamification, or it can be just fun. They can be given an opportunity in that space, enter the game space as a team or any unique avatar, and interact with each other according to the goal of the game ” (P16).

The design of scientific societies by students with the support of the university was also important.

” Now, the IR SOME Association (Iranian Society of Medical Educationalists) has been held. For the Science Olympiad, a number of students have registered, and the students themselves manage a sequence of workshops, so the interaction between the students is very good now. These groups were formed because all the students had a common goal, and the interaction was good ” (P6).

” One of the solutions is to create a space for them to interact outside of the academic space ” (P16).

Implications

To strengthen the quality of interpersonal interactions (teacher-student and student-student interactions), empowering instructors and qualifying them is significant, considering their critical role in developing, maintaining, and facilitating the interaction of online classes. In addition, learners need to be trained to take responsibility for more participation in online classes and increase self-regulation skills and soft skills. In other words, the results of this study give teachers the insight to keep essential issues in mind when developing their online courses and students to be aware of their roles in the online learning process. Also, the characteristics of simultaneous and non-synchronous platforms, social messaging networks, and learner support are crucial.