Where do we go from here? Evaluating the effectiveness of a nursing MOOC over six years

Massive open online courses (MOOCs) have transformed global education, yet their long-term effectiveness and evolving learner engagement remain underexplored. This study aims to comprehensively evaluate a nursing MOOC over six years, examining learner engagement, identifying distinct learner profiles, and assessing changes across different developmental stages to inform future MOOC design.

A retrospective study was conducted on 4171 completers of the Medical Nursing MOOC on a Chinese MOOC platform, covering eleven semesters from 2018 to 2023. Latent profile analysis (LPA) categorized learners based on unit test scores, and profile distributions were compared across the MOOC's developmental stages.

The Medical Nursing MOOC attracted 69,642 registrants with a 5.99% completion rate. Among the 4171 individuals who completed the course, latent profile analysis identified six distinct learner types, demonstrating significant differences in overall learning effect (H = 2823.604, P < 0.001). The chi-squared analysis revealed significant differences between the proportions of the six profiles regarding MOOC developmental stages (χ² = 695.464, P < 0.001).

Findings highlight the evolving role of MOOCs in nursing education. Despite challenges in long-term engagement, the increasing proportion of highly engaged learners and declining dropout rates indicate growing effectiveness and sustainability. These insights provide evidence-based guidance for optimizing MOOC design and implementation.