Digital transformation in nursing education: students’ satisfaction, academic self-efficacy, and challenges with interactive e-books

With the increasing integration of digital tools in nursing education, interactive e-books have emerged as innovative resources that promote engagement, flexibility, and active learning. However, evidence regarding their effectiveness in enhancing nursing students’ satisfaction and academic self-efficacy, as well as the challenges affecting their use, remains limited. This study aimed to assess nursing students’ satisfaction, academic self-efficacy, and perceived challenges related to the use of interactive e-books. A mixed-methods design was employed among 500 undergraduate nursing students at Capital University, Egypt. Quantitative data were collected using validated instruments measuring satisfaction and academic self-efficacy. Descriptive statistics and correlation analysis were used to examine relationships between variables, while multiple linear regression analysis was conducted to identify key predictors of both outcomes. In addition, qualitative data were collected using semi-structured questionnaires and analyzed thematically to explore students’ perceived challenges related to the use of interactive e-books. The majority of students reported high levels of satisfaction (72.2%) and self-efficacy (63%). A strong positive association was observed between satisfaction and self-efficacy. Multiple linear regression analysis identified academic performance (GPA) as a significant predictor of satisfaction (β = 0.185, p < 0.001) and self-efficacy (β = 0.198, p < 0.001). Prior training was also a significant predictor of satisfaction (β = 0.142, p = 0.014) and self-efficacy (β = 0.155, p = 0.005). Age and academic level were additionally significant predictors across both models, whereas gender was not statistically significant ( p > 0.05). The regression models explained a moderate proportion of variance in both outcomes, emphasizing the multifactorial nature of satisfaction and self-efficacy in technology-enhanced learning environments. Qualitative findings revealed key barriers, including technical limitations, content navigation difficulties, limited access to devices and internet connectivity, cognitive overload, and insufficient digital literacy. Interactive e-books can enhance nursing students’ satisfaction and self-efficacy; however, their effectiveness depends on students’ academic preparedness, technological accessibility, and system design. Addressing identified barriers and strengthening digital readiness are essential for optimizing the integration of interactive e-books in nursing education. Not applicable.