Attitudes Toward E-Learning Among Undergraduate Nursing Students in Greece: A Multicenter Cross-Sectional Study

Background/objectives E-learning has become an integral component of higher education, including nursing programs that combine theoretical instruction with laboratory and clinical training. This multicenter study investigated undergraduate nursing students' attitudes toward e-learning in Greece and examined the individual, educational, and technology-related factors associated with these attitudes. Methods A multicenter cross-sectional study was conducted among 1,148 undergraduate nursing students from all eight public university nursing departments operating in Greece during the study period. Data were collected using the Greek version of the Attitude toward e-Learning Scale among Nursing Students (ALSNS). Statistical analyses included descriptive statistics, comparative tests, and Bonferroni-adjusted post hoc analyses. Results Students generally recognized the flexibility and accessibility of e-learning and expressed positive intentions toward using digital educational technologies. However, they remained cautious regarding fully online approaches as a replacement for conventional nursing education and showed a preference for blended learning approaches. More positive attitudes were associated with younger age, university affiliation, higher digital competence, higher family income, and advanced year of study (p < 0.05), whereas gender differences were negligible (Cohen's d < 0.15). Conclusions Undergraduate nursing students viewed e-learning as a valuable complement rather than a replacement for conventional teaching. The findings suggest that blended learning models may be appropriate, integrating digital instruction with face-to-face nursing education while considering differences in students' digital readiness and educational context. Future longitudinal studies should examine whether positive attitudes toward e-learning translate into improved academic outcomes and clinical competence.