Root Kustritz, Margaret VLashbaugh, Kristy DRendahl, Aaron KMalone, Erin DLarsen, Roxanne JBurton, Erin NGordon-Evans, Wanda J2024-02-142024-02-142023Educ Health Prof 2023;6:121-6.https://hdl.handle.net/11299/261000Background: Students expressed concern about having been forced to move toward more online or virtual learning starting in March 2020 with the coronavirus disease pandemic. Our hypotheses were the following: if a course is well designed, success in the course is not dependent on student comfort level. If a course is not well designed, student comfort level is a significant factor, and those students who are more comfortable with independent learning may outperform students who are less comfortable in courses offered virtually. Materials and Methods: Student performance, as demonstrated by examination scores, was compared with their comfort as independent learners and with the quality of online/virtual course offerings. Data analysis consisted of descriptive statistics and a linear mixed model. Results: Student performance was directly associated with comfort level, with those students who were less comfortable performing less well. Student discomfort with independent learning of online/virtual coursework could not be mitigated by increasing course quality in this study. Conclusions: Students may benefit from understanding what about independent learning makes them uncomfortable and directly addressing it. Instructors can do much to improve the learning experience in online courses by following published best practices. It may well be that many of the reported negatives of online learning will ease with time as students and instructors become more accustomed to independent learning paradigms.enE-learning, independent learning, instructional design, student comfort levels, teaching and learningArticle10.4103/EHP.EHP_8_23