Objective
This study aimed to determine the perceived challenges of e-learning experienced by undergraduate nursing students during the COVID-19 pandemic, and to explore factors impacting these challenges.
Methods
A cross-sectional exploratory design employing a 53-item validated, pre-tested and pilot-tested questionnaire administered to 184 nursing school students at Saudi Arabia was implemented. Data was collected using convenience sampling method, followed by descriptive and inferential statistics conducted at significance level 0.05 using Statistical Package for Social Sciences (SPSS) version 21 software.
Results
Most of the students (71%, n=71) showed positive attitude scores (≥60) towards e-learning as opposing to 29% (n=54). E-learning was reported to be useful (mean score: 3.26±0.88) and is accompanied with self-efficacy (mean score: 3.04±0.82) and time-management (mean score: 3.39±0.73).
Encountered barriers included unready institutional infrastructure with lack of technical support (3.14±1.3), training (3.03±1.3) and poor internet connections (3.92±1.3). Feelings of uneasiness (mean score:2.77±1.5), confusion (2.64±1.4), stress and nervousness (mean score: 2.55±1.4) were reported. Online tests were associated with fear (2.66±1.3). Younger age (≤ 22 years) showed significantly more frequencies of positive attitudes toward e-learning versus older ages (≥23 years; p-value<0.01). Females were more likely to show more positive attitudes towards e-learning versus males (p-value <.001).

Conclusion
Despite the general positive attitudes towards e-learning amongst nursing students, e-learning was associated with anxiety due to lack of training, institutional infrastructure readiness. Initiatives should be directed toward mitigating these obstacles to enhance the efficacy and educational benefits of e-learning.
Keywords: COVID-19 pandemic, e-learning, challenges of e-learning, nursing students, nursing, online learning, nursing education, distance learning, web-based learning