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BackgroundTo continue delivering the courses despite school closure during the covid-19 pandemic, the University of Rwanda abruptly shifted its teaching from traditional physical to online teaching. This was the compulsory medium of teaching during the lockdown period. This sudden change did not allow for adequate preparation for students. ObjectivesTo assess the preparation of learners to use the e-learning platform, and to explore the factors that enabled or inhibited learners’ use of the e-learning platform. MethodThis was a cross-sectional quantitative research design study done between June and July 2020. An online questionnaire was sent to all students registered in the College of Medicine and Health Sciences for the academic year 2019-2020. ResultsA total of 446 students completed the questionnaire. Students reported not being adequately oriented and unprepared to effectively use e-learning. Students were motivated to use e-learning when the learning objectives were clear, interactive, with engaging materials. Inadequate e-learning infrastructure, limited access to internet connectivity and inadequate devices were identified as the strongest barriers of using e-learning. ConclusionThe covid-19 pandemic has brought a transformational opportunity to embrace a blended learning approach. To sustain such a transformation, proper and timely planning and strategies need to be invested. Rwanda J Med Health Sci 2022;5(1):99-112

The future of the nursing profession in Rwanda in large part depends on the nursing students who join the workforce and the training they have received. Preparing them to enter the profession with the necessary clinical competencies, values, and attitudes requires practice-based learning environments to become more supportive of facilitating their professional development. The current learning environments experienced by nursing students in Rwanda, and the values, assumptions, practices, and behaviours of different stakeholders involved in preparing them to enter professional practice, have not yet been explored. The aim of this study was to address that knowledge gap by exploring the values, assumptions, practices, and behaviours within acute care practice environments and an educational institution within a resource-limited context like Rwanda and how the cultural aspects of these environments influence the development of nursing students as future nurses in professional practice. Guided by a constructive lens, this study used focused ethnography to explore the values and assumptions co-constructed by multiple stakeholders involved in the professional growth of students, particularly from the perspective of students, staff nurses, clinical instructors, and nurse leaders. Individual interviews, observations, and document reviews were used as data sources. Findings from this study revealed that the acute care practice learning environment is a multifaceted entity influenced by interconnected sets of values, assumptions, behaviours, and practices that intersect at institutional, unit, and individual levels. Nurturing, professional gatekeeping and engagement emerged as positive values and assumptions that guided clinical settings and academic program members in their behaviours and practices to nurture and support nursing students as they develop into future nursing professionals. On the other hand, collaboration, structural, and interpersonal barriers prevented the acute care practice environments and the academic institution from enacting these positive beliefs and values. This disconnect between values and the actual enacted practices and behaviours within acute care practice units and by individuals constrained practice environments and academic programs from creating and sustaining enriched and positive environments conducive to preparing students for professional practice. The findings of this study illuminate that building and sustaining a nurturing and positive learning environment that fosters the professional development of nursing students requires a multifaceted approach that engages every concerned stakeholder in “co-creating” a learning culture to close the existing gap between the desired learning environment and the actual unit practices and individual behaviours. Recommendations related to policy, education, practice, and research have been formulated and addressed in this dissertation.