Synchronous Hybrid Teaching on the Nursing Degree: Opinions, Satisfaction Levels and Student Results—An Observational Cross-Sectional Study During the COVID Pandemic

Background: During the COVID-19 pandemic, synchronous hybrid teaching was implemented in the Nursing Degree at the University of Burgos to enable simultaneous face-to-face (F2F) and online attendance. Although this teaching model has remained of interest beyond the pandemic, evidence comparing educational outcomes according to attendance modality remains limited in nursing education. Objective: To compare educational outcomes, satisfaction levels, and student perceptions associated with F2F and online attendance within a synchronous hybrid teaching model. Methods: An observational, cross-sectional, comparative study was conducted among second-year nursing students enrolled in three theoretical courses (Pharmacology, Research Methodology and Information Systems, and Nutrition and Diet Therapy) during the 2020–2021 and 2021–2022 academic years at the University of Burgos (Spain). Data were collected through knowledge assessments, satisfaction questionnaires, and open-ended survey responses. Comparisons between attendance modalities were performed using parametric and non-parametric tests as appropriate. Mean differences and 95% confidence intervals (95% CI) were reported. p-values were adjusted for multiple comparisons using the Benjamini–Hochberg false discovery rate (FDR) procedure. Results: The association between attendance modality and educational outcomes varied across study units and assessment methods. At class level, the largest differences were observed in Nutrition and Diet Therapy, where F2F students obtained higher knowledge scores than online students (mean differences ranging from 2.41; 95% CI 0.34–4.47 to 3.71; 95% CI 2.13–5.30 points). In end-of-course assessments, mean knowledge scores were higher among predominantly F2F students in all study units and academic years, although none of these differences remained statistically significant after FDR adjustment. Satisfaction results also varied according to study unit, although attention was consistently rated more favorably in F2F classes across all end-of-year evaluations, a finding that remained significant after FDR adjustment. Qualitative findings showed that students associated F2F attendance with greater attention, understanding, and interaction, whereas flexibility, comfort, and organizational advantages were the main reasons for preferring online attendance. Conclusions: Associations between attendance modality, knowledge assessment scores, and student satisfaction varied according to study units and assessment method. In several analyses, students attending F2F classes reported more favourable learning experiences and obtained higher scores than students attending online classes. However, given the observational nature of the study, these differences should be interpreted cautiously. The findings suggest that attention, interaction, and student engagement deserve particular consideration when implementing synchronous hybrid teaching in undergraduate nursing education.