Participants

The sample comprised 20 teachers in the field of health sciences, including eight males and twelve females. The ages of the participants ranged from 30 to 57 years, with an average age of 40.65. The teachers held various academic titles: six as associate professors, ten as assistant professors, and four as a lecturers. They were teaching in several study programs, covering a broad spectrum of health sciences disciplines, including but not limited to Health Prevention (doctoral level – 3rd cycle), Nursing (bachelor’s and master’s levels – 1st and 2nd cycles), Dietetics (bachelor’s and master’s levels – 1st and 2nd cycles), Physical Therapy (bachelor’s and master’s levels – 1st and 2nd cycles), and Kinesiology (bachelor’s and master’s levels – 1st and 2nd cycles).The participants were involved in all educational levels, from undergraduate to doctoral studies, with sixteen teachers teaching at both the first and second cycles, and four taught across all three cycles. Regarding tenure, the length of employment at the institution varied significantly among participants, ranging from 4 to 31 years, with an average tenure of 14.50 years. Prior to the COVID-19 pandemic, most participants had limited experience with digital pedagogy and e-learning tools, as traditional face-to-face teaching methods predominated.

Structural analysis

The structural analysis was conducted by clustering items based on word similarity, using the Pearson correlation coefficient as the primary metric. The average Pearson correlation coefficient across the clusters was 0.839, indicating a high degree of similarity among the items. This high level of similarity allows for robust analysis as it indicates that the transcripts can be grouped together effectively, highlighting patterns and themes common to the participant group [19].

In the next stage of the analysis, word frequency was assessed (Fig. 1) and then contextualized within the transcripts in the first phase of the thematic analysis. The most prominent terms in the word cloud, ‘teacher’, ‘students’, ‘technology’, and ‘digital’, highlight the key themes present in the data. Their prominence suggests that participants frequently explored the connections between teachers, learners, and the role of technology within the educational setting. Other notable words, such as ‘pedagogically’, ‘process’, and ‘support’, point to concerns about instructional methods, educational processes, and the need for support systems, both for teachers and students, when it comes to technology-enhanced learning. In this context, the presence of words like ‘computers’ and ‘content’ further supports this, suggesting that specific technologies and materials were also significant points of discussion.

Fig. 1
figure 1

Thematic analysis

In exploring the integration and impact of digital technology within higher education, particularly in the field of health sciences, our thematic analysis identified three key themes that describe the teachers’ experiences and perceptions: (1) Digital transformation in education, (2) Educational efficacy and evolution, and (3) Overcoming barriers and embracing opportunities (Table 1).

Digital transformation in education

The theme ‘Digital Transformation in Education’ represents the shift from traditional educational approaches to those that integrate digital tools within pedagogical practices, alongside the development of digital literacy skills. It examines the proactive engagement of teachers with innovative digital methodologies and approaches, along with their commitment to enhancing their own and their students’ proficiency in adapting to the evolving educational environment within health science education.

Within the sub-theme of ‘Pedagogical practices and innovations’, teachers are portrayed as not merely incorporating technology but are actively seeking to enhance their learner centred approach through digital means. The emphasis is on leveraging technology to create a more interactive and immersive learning environment. The discussions within the focus groups reflect a keen interest in evolving educational strategies that go beyond traditional lectures, favouring a model where technology-enhanced learning acts as a facilitator for a more dynamic pedagogical process, but still does not take the lead. The exploration of cutting-edge technologies such as virtual reality and simulations suggests a shift towards experiential learning, where students can engage with complex subject matter in a more concrete and tangible way.

“I try to include more interactive elements like quizzes and videos to break up the traditional lecture format. It’s about finding the balance where digital aids the learning process without overshadowing the content itself.” (FG 2).

Within the scope of digital integration in higher education, a foundational level of technological adoption has become a norm, which is reflected throughout the interviews. However, this established baseline serves only as a starting point from which individual teachers can further implement and innovate their approach to teaching. The potential for personalization through digital means—such as the adaptation of e-learning platforms and the integration of new technological advancements, mentioned in the interviews—presents opportunities for teachers to tailor and enhance the learning experience to meet the diverse needs of students. Reflecting on this, one educator remarked:

“Now there is not much left to add. It seems to me that there is some basis for a certain minimum implementation of the pedagogical process, which we all use to a greater extent, but then it depends on the individual what we will use for some upgrade.” (FG 1).

The second sub-theme, ‘Digital literacy and skills development’, describes the readiness of both students and teachers to effectively engage with digital technologies. The interviewees reveal that while students are generally adept at using technology, there is a spectrum of proficiency that must be acknowledged and addressed. As one educator pointed out:

“We have to go a step further to get advanced users who know how to connect two applications, who know how to connect data from different sources. I am sceptical here, mainly because in our profession we use the term ‘digital natives’, and we count on these to be our students. Indeed, they are digital natives, but we know that means a low-level user.” (FG 2).

Teachers also recognize the need to bridge the gap between basic user capabilities and advanced proficiency. There is a clear call from the focus group participants for developing a comprehensive digital literacy curriculum that not only familiarizes students with digital tools but also empowers them to use these tools critically and creatively. Concurrently, there is recognition of the professional development needs of teachers themselves. The transition to digital-centric teaching methodologies and associated didactic approaches requires teachers to be continuously updated and skilled in the latest digital tools and practices. The majority of interviewees recognized this as a challenge but also as a necessity:

“I follow good practice in this area. And when I get a little organized in my head, and an opportunity presents itself, then I use it, if, of course, it’s suitable. How do I prepare it? Of course, first I place everything technically as I imagined in the e-classroom, then I make a test case, I ask my colleagues if they would like to add or improve anything.” (FG 2).

Educational efficacy and evolution

This theme describes the transformative effects of digital technologies on educational practices and outcomes, particularly at the start of the COVID-19 pandemic, which all interviewees recognised as a catalyst for change. It illustrates how digital tools have reshaped teaching and learning dynamics, focusing on the tangible impacts on educational efficacy and the evolution of communication and collaboration methods.

In this context, the subtheme ‘Impact and outcomes’ addresses the direct effects of digital technology integration into education systems. All teachers have observed significant changes in how content is delivered and how students engage with learning materials. The shift from traditional classroom settings to digital platforms has introduced both challenges and opportunities. One educator highlighted the necessity and transformative potential of digital tools during the pandemic:

“COVID-19 acted as a catalyst for embracing digital technologies, which allowed us to maintain educational continuity. However, it also exposed the need for substantial pedagogical support to optimise these tools effectively.” (FG 2).

The technology integration has varied impacts on learning quality and student engagement. Some teachers noted improvements in accessibility and flexibility, which allowed students to learn at their own pace and revisit complex material as needed. Conversely, others pointed out potential drawbacks, such as diminished interpersonal interactions and the risk of disengagement. This dichotomy is captured in the following quote by one of the teachers:

“Digital tools have enabled a broader reach and more flexible learning environments, but they cannot fully replicate the spontaneous interactions that occur in a physical classroom.” (FG 3).

The ‘Communication and collaboration’ subtheme explores the new interactions among students and between students and teachers, which resulted from this transformation to digital pedagogy. The widespread adoption of tools such as LMS, video conferencing, and collaborative platforms has transformed traditional communication paradigms, as recognised by all teachers:

“We’ve moved from email and face-to-face meetings to real-time collaboration on digital platforms. This has not only increased efficiency but also allowed for a more inclusive approach where every student can contribute regardless of their physical location.” (FG 1).

The integration of social media and other collaborative tools has also fostered a new culture of learning where the sharing of resources and peer feedback is more fluid and instantaneous. According to some interviewees, the use of social media has stimulated lectures in ways that were not possible before the pandemic. However, this shift requires both students and teachers to develop new digital literacies to navigate these platforms effectively. As stated by an educator:

“The use of collaborative platforms has greatly enhanced the way we share resources and conduct group projects. However, it necessitates an ongoing effort to ensure all participants are proficient in these technologies to fully benefit from them.” (FG 2).

Overcoming barriers and embracing opportunities

This theme recognizes the different perspectives of digital tools which, while facilitating advanced educational practices, also present significant barriers that require a thoughtful approach to finding suitable solutions. The integration of digital technologies in education is not without its challenges, ranging from infrastructural inadequacies to resistance among teachers. These barriers often necessitate innovative solutions to ensure effective technology use and maintain educational quality, as many in the focus groups have pointed out. One notable challenge is the inconsistency in technology infrastructure, which can severely limit the effectiveness of digital learning tools. One educator stated:

“We face a continuous challenge with the lack of necessary hardware and software, which impedes our ability to fully implement digital learning environments.” (FG 3).

Furthermore, there is often a significant learning curve associated with adopting new technologies. Teachers must not only become proficient themselves but also ensure that their students are capable of using these technologies effectively. The complexity of this issue, recognized by the majority within the focus groups, is compounded by varying levels of digital literacy among students and teachers, which can hinder the integration of technology into the curriculum. As one educator highlighted:

“The adoption of digital tools requires us to develop and continuously update our digital literacy skills, a process that can be daunting for both experienced teachers and newcomers alike.” (FG 1).

In response to these challenges, it has become obvious that many educational institutions have started to develop comprehensive training programs for both teachers and students. As discussed in one of the focus groups, these programs are designed to bridge the digital literacy gap and enhance the overall effectiveness of technology use in education:

“We have initiated several professional development workshops focused on digital competencies to better prepare our teachers and students for a technology-driven educational landscape.” (FG 3).

Security, privacy, and ethical concerns, among others, also present significant challenges, especially with the use of data-intensive technologies. The need for robust security measures and clear ethical guidelines is critical, as one educator explained:

“Ensuring the privacy and security of our digital platforms is paramount. We are constantly updating our protocols to prevent data breaches and protect our stakeholders’ information.” (FG 2).

Innovative solutions such as the development of custom educational software and platforms that meet the specific needs of educational institutions in the field of health sciences have been recognized as vital by teachers. These tailored solutions often include enhanced security features and are designed with the input of teachers to ensure they effectively meet pedagogical needs.

“Individualized educational platforms, developed with our input and experiences, are critical in health sciences education. They address our specific pedagogical needs, which, to be honest, exist in nursing […] and some sort of security features should also exist.” (FG 1).

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