Background; the use of information technology and the internet as teaching and learning tool is rapidly expanding into today's learning environments. Education institutions in the Kingdom of Saudi Arabia (KSA) are preparing students for a rapidly changing information and technology driven world. The KSA needs graduates who are ready for the workplace and who have a high level of knowledge and confidence in the use of technology to help them in their lifelong learning. Since e-learning is conducted using the Internet and World Wide Web, the learning environment becomes more complicated. Students' initial perceived satisfaction with technology-based e-learning will determine whether they will use the system continually. So this study aimed to assess perceived e-learner satisfaction and investigate the preceding factors influence on nursing students' satisfaction with e-learning experience in King Khalid University. Subjects: A convenience sample of 135 female nursing students affiliated to University Center for Female Studies, King Khalid University was enrolled in this study. Tool: data were collected by using three tools. The first was concerned with collecting data related to sample characteristics, the second concerned with identifying the factors that may affect the e-learner satisfaction with e-learning. The third concerned with measuring the learner satisfaction with e-learning. Results; revealed that 61.5% of participant students were unsatisfied with their e-learning experience and learner attitude towards computer, learners' computer anxiety, e-learning course flexibility, e-learning course quality, technology quality, perceived usefulness, perceived ease of use, diversity in assessment, and learner perceived interaction with others were the critical factors affecting learners' perceived satisfaction. Recommendation &implications: Helping students build their confidence in using computers

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Background Flipped learning excessively boosts the conceptual understanding of students through the reversed arrangement of pre-learning and in classroom learning events and challenges students to independently achieve learning objectives. Using a gamification method in flipped classrooms can help students stay motivated and achieve their goals.  Methods This study adopted a randomized controlled study design with a pre-test and post-test and involved 128 nursing students at Mansoura University. This study randomly divided the students into the study and control groups. Data were collected at three time points using six tools. In the intervention group, Moodle was gamified for 6 weeks.  Results A significant difference in the students’ self-confidence (p = 0.021), skills knowledge (p < 0.001), intensity of preparation (p < 0.001), and motivation (p < 0.001) was observed between the two groups; however, no difference in the students’ skills performance (p = 0.163) was observed between the two groups after using gamified flipped classrooms. Conclusions Compared with the traditional flipped classrooms, gamified flipped classrooms improved nursing students’ motivation, intensity of preparation, skills knowledge, and self-confidence during laboratory clinical practice. Thus, gamification is a learning approach that can be implemented in conjunction with the flipped classroom model to motivate students to participate in the learning process. Trial registration. Prospectively registered with ClinicalTrials.gov on 26/04/2021; registration number NCT04859192.