How do postgraduate online distance learners understand ‘sense of belonging’ and why it matters: a qualitative study

Background Sense of belonging (SoB) may support participation and engagement in online distance learning (ODL), yet little is known about how postgraduate health professions learners understand and experience it. This study explored learners’ accounts of belonging in postgraduate ODL and used the findings to develop an integrated conceptual framework. Methods A qualitative multi-site case study was conducted across four medical universities in Pakistan, each offering postgraduate health professions education programmes and treated as a distinct case to capture both shared and institution-specific patterns. Forty learners took part in semi-structured online interviews. Data were analysed using reflexive thematic analysis, with attention to shared and divergent experiences across sites. Results Learners described belonging through emotional connection, ownership, interpersonal affiliation, and psychological safety. Six interconnected themes explained how belonging developed or weakened. Three concerned relational experiences: building community through shared experiences; being recognised, heard, and valued; and feeling safe, supported, and included. Three concerned the conditions that shaped participation and connection: balancing flexibility and participation; technology as a bridge and barrier to belonging; and fostering connection through responsive presence. Learners’ accounts showed that access to an online programme did not, by itself, produce a sense of membership. Conclusions Sense of belonging in postgraduate ODL was shaped through continuing interactions among learners, other people, and the conditions that enabled participation. The proposed framework distinguishes how learners understood belonging from the relational experiences and contextual conditions through which they encountered it. Its suggested links to longer-term learner outcomes require further study.