The World Health Organization proclaimed a pandemic state on March 11, 2020, following the first report of the new coronavirus disease (COVID-19) epidemic at the end of December 2019 in Wuhan, China [1]. Italy was the first nation in Europe to be afflicted by the epidemic, which started on February 21. Lombardy was the region with the highest number of COVID-19 cases and fatalities (representing 39 and 48% of the total, respectively).

Online learning is the transfer of knowledge via synchronous and asynchronous internet technologies. These platforms enable students to communicate with their instructors and fellow students while maintaining a social distance [2]. Students and teachers who utilize online technology for learning must be able to use it to establish and sustain healthy social relationships [3]. Other elements, such as the availability of appropriate facilities, infrastructure, and the financial situation of the students, play a significant role in online learning in addition to the efficient use of technology [4, 5].

Online learning has grown excessive and pervasive, and as a result, it negatively impacts students’ mental and emotional well-being and their ability to live fulfilling lives around the world. This is true even though asynchronous and synchronous types of distance learning have been more or less organized properly. These psychological concerns frequently make it difficult for students to adjust to online learning. Furthermore, the enormous impact of the pandemic (and everything associated with it) on young adults' psychophysical state, emotional well-being, and physical health results in significant organismal tension, which, when combined with other detrimental factors causes diseases, functional disorders, and, ultimately the development of organ pathology. It's possible that the prevalence of sadness, worry, exhaustion, etc. among young people will sharply increase.

However, to what extent students perform equally well in online and face-to-face classes is the subject of conflicting research. According to several studies, there are no performance differences between face-to-face and online learning modalities [6-8]. Contrarily, other research indicates that online students tend to drop out more frequently than their face-to-face counterparts [9, 10]. Researchers are paying more attention to the possibility that some student types may benefit from online learning more than others. Adult learners, or those who are 24 years of age or older, are one category that has received a lot of attention [11]. Online courses, on the one hand, boost accessibility for adult learners, who are more likely to have to balance employment and family obligations while earning a degree [12, 13]. Because they are more independent and self-directed, adult learners might perform better in online courses [14]. However, they might not be as efficient at navigating online learning environments, which could have an impact on their performance [15, 16].

The COVID-19 pandemic has impacted young people's mental health in a variety of ways, including social isolation and the nearly total loss of all social activities, as well as short-term effects on school, employment, and training [17]. Predictions of a severe economic catastrophe may have an impact on young people's psychological well-being. Immigrants, children, women, and persons with low education levels are particularly sensitive to the effects of changing labor markets on their physical and emotional health. Because of societal unrest, including financial insecurity, the need to take better care of their health, not knowing when the pandemic will stop, and the uncertainty of the long-term effects, the COVID-19 pandemic poses a threat to the well-being of the younger generation and their families [18, 19].

According to Sahu [20], the COVID-19 pandemic caused numerous psychological shocks and had a detrimental impact on students’ psychological well-being, which immediately caused severe job stress and anxiety [21]. Cao et al. [22] studied the psychological impact of the coronavirus outbreak on university students in China. They discovered a detrimental effect on the students' performance as well as a severe psychological burden. Previous studies confirmed that students' psychological pressure and academic progress are both severely impacted by uncertainty [23, 24].

We have chosen to concentrate on how young people see the current developments as a result of the pandemic's psychological effects. New difficulties have been confronted by young people in training. We conducted this study to examine the effects of online education on students' well-being, amid the isolation conditions imposed by the Pandemic, in order to better understand the changes to the educational system and the uncertainty and hazards represented by a completely new situation. Similar to other countries, Saudi Arabia abruptly switched from on-site to online education during the epidemic based on these factors. Our study seeks to determine how switching from traditional classroom education to online education affects students' academic performance and psychological well-being. As a result, the following research questions served as its guiding principles:

1. To find out students’ perceptions of the advantages and disadvantages of e-learning and face-to-face learning.

2. Is there any impact of different aspects of e-learning and face-to-face learning on student learning?

3. Is there any difference between e-learning and face-to-face learning in terms of knowledge, clinical skills, and social competence?

4. Is there any relation between the positive and negative perception of e-learning/face-to-face learning and student psychological well-being?

5. To find out the relationship between e-learning/face-to-face learning on the factors of psychological well-being i.e. autonomy, environmental mastery, personal growth, positive relations with others, the purpose of life, and self-acceptance.

In this empirical study, we evaluated KFU students’ perception of online learning during the COVID-19 pandemic. Ease of access to educational materials and the ability to record a meeting were shown as the strongest advantages of online learning among participants in our survey. Remote access is of particular importance during the COVID-19 pandemic, but it can also reduce the cost of accommodation and transportation in other settings [58]. Through the method of e-learning, we can deliver learning materials to the students quickly and efficiently, standardized, and if needed, updated [59]. Two methods of content delivery are possible: instructor-led learning and self-directed learning. With self-directed online learning, the learner can control his own schedule. Self-directed online learning can perform better than traditional face-to-face learning techniques, according to recent research by Peine et al. [60].

There are many disadvantages of the e-learning method. Technical problems and a lack of self-discipline are the top issues that respondents in this survey mentioned. This result is in line with other recently released research examining how students felt about taking online classes during the pandemic [61].

Many nations have abolished clinical clerkships. The lack of real patients in a clinical setting also presented a problem for medical institutions, and online learning cannot completely replace it [60]. To some extent, using virtual patients (VPs) could be a solution to this problem. According to their respondents, Gherhes, et al. [62] highlighted three primary benefits of e-learning: time efficiency, convenience, and accessibility. However, the respondents felt that the biggest disadvantage of e-learning was the loss of interaction, which was confirmed by those who said they missed talking to their peers.

Unexpectedly, 47% of survey respondents had never participated in any type of online learning prior to the COVID-19 pandemic, which may be the main cause of technical problems being the biggest drawback of e-learning in this study. A reliable internet connection and the required hardware and software are necessities for e-learning [63]. Before and during an online course, the IT department should provide technical support and direction to ensure that both students and lecturers are comfortable using the equipment. The learning process might be hampered by a lack of interaction between students and facilitators as well as by unclear learning objectives [64]. According to Stacey and Gerbic [65], students' levels of self-discipline might grow as they mature, which is consistent with the results of our study.

In our study, we made the assumption that students could expand their knowledge through e-learning to the same extent as through traditional learning, however, the actual results showed a significant difference. Results indicated that e-learning is clearly less effective than traditional methods of learning in terms of improving students' clinical and social skills. E-learning is most effective when used in conjunction with traditional classes to teach clinical skills. Video instruction appears to be superior to text-based materials for teaching practical skills [66] and it is consistent with Peyton's 4-step skill acquisition strategy [67]. Remote standardized patients (RSPs), who interact with students online, offer an intriguing approach to encouraging social skills. RSPs are able to illustrate a particular clinical scenario while also evaluating the student and giving immediate feedback. The use of RSPs and Skype and their influence on residents' social skills were investigated by Langenau et al. [68]. 90% of the participants in their study agreed that this style was successful in teaching communication skills [68].

It's interesting to see that respondents felt they were less active in e-learning than in traditional face-to-face lectures. One of the causes can be that e-learning courses weren't developed with an interactive approach. During the COVID-19 epidemic, just 15% of respondents cited class interaction as an advantage of online learning. E-learning was also rated less favorably by participants and as being less participatory [69]. The level of interaction in online learning can be increased in a variety of ways. Gamification is a novel and fruitful approach in which “game design aspects are employed in non-game circumstances.” [70]. Gamification has been demonstrated to be successful in various domains, particularly in education, in a systematic review undertaken by Hamari et al. [71]. Through social and collaborative learning, we can also make online learning more interactive. The use of social interaction between students and teachers is permitted when using this method. In an open forum, they might collaborate to exchange concepts and broaden their knowledge. In their study, Bergl et al. [72] found that the majority of locals believed Twitter improved their education.

This study provides some interesting results with regard to the relationship between online learning and its impact on psychological well-being in a situation that was very stressful, as is the case with university students during the pandemic. Another objective of our study was to check if any relationships exist between the positive and negative perception of e-learning and student psychological well-being and its six dimensions. We didn’t find any significant relationship between positive and negative perceptions of e-learning/face-to-face learning with psychological well-being and its dimension except autonomy. This result demonstrates that students with a negative perception of e-learning have a higher individual capacity to maintain their individuality in different contexts and situations with determination, independence, and personal authority [73]. In line with previous research conducted by Hidayat et al. [74], According to Rahmasari et al. [75], students are not yet prepared to learn online because of insufficient technology and their preference for in-person interactions with peers and teachers. Another study by Rattelle et al. [76] and Weiting [77] examined the relationship between psychological well-being and perceived autonomy. Except for the volitional dimension of autonomy, both studies indicated a positive correlation between perceived autonomy and well-being.

In this study, we also found significant relationships between traditional face-to-face learning and autonomy, personal growth, and positive relations with others. The result recommends that students with a positive perception of face-to-face learning also have high scores on autonomy, personal growth, and positive relations with others. These findings are similar to those of other studies [78, 79].

The students felt that the online learning environment had a detrimental impact on their personal and academic growth. They were concerned that they would struggle to finish their coursework and that they wouldn't be able to appear for their exams on time. Adesina and Orija [80], in contrast to our findings, discovered that students believed online learning offered five main advantages: career growth, scheduling flexibility, self-paced learning, a broader global viewpoint, and skill development.

This article discusses a current and very important topic, focusing on the analysis of students’ learning and psychological well-being during the transitional period from traditional face-to-face to e-learning during the period of the COVID-19 pandemic. The effects of online education during the COVID-19 pandemic on students’ well-being were analyzed. The authors’ general perspective has been confirmed, and our findings corroborate those of Bali and Liu [81] and Platt, Raile, and Yu [82], showing that students have clear perceptions of online education, and consider it essential for their career success but hey have rated traditional way of teaching is much better than e-learning.

All aspects of teaching and learning in higher education have changed as a result of the usage of the e-learning technique. Students have faced many problems and differences in perception due to the transfer of content from traditional teaching to online teaching [83]. Some students believe online learning is ineffective since there is little interaction between students, faculty members, and other classmates and more interaction with technology. To improve their teaching and learning methods, higher education institutions should review the input from their students [84].

This study demonstrated the value of e-learning as a teaching strategy. Our research participants believed that e-learning is well acceptable and useful for advancing knowledge. Clinical and social skills development should also be prioritized in addition to knowledge acquisition. Students should be able to interact with the materials and receive feedback as part of e-learning, which should focus on more than just content delivery. A well-planned strategy and a more proactive approach are needed to integrate online learning into the curriculum successfully.

The COVID-19 pandemic and its associated consequences will persistently affect college students’ mental well-being. Mental health services must be delivered to combat the mental instability of the students. In addition, Universities and colleges should create an environment that will foster mental health awareness among King Faisal University students. It is crucial to develop healthy policies and health promotion initiatives at the university that stress building healthy living, working, and learning environments for students and staff, especially when tailored to the specific physical and mental health challenges identified in this study.

This study has several limitations. The respondents came from King Faisal University, and most of them (56%) were female students. However, the sample is representative, but most students who showed interest in participating in this study are females. A wider institutional range would provide a more complex picture of the perceptions of young people studying in the Saudi Arabia university system with regard to online teaching and learning. This study was limited to only one university and did not analyze, by comparison, the perceptions of young people studying in other Universities. An evaluation of the teachers' impressions of the same research questions would reveal the perspectives of several groups who played distinct roles within the same process but shared similar objectives. Another drawback is the evolving pandemic because it is uncertain how quickly infections will start to fall. Given the existing issues with online learning and the long-term losses in terms of students' knowledge and skills in accordance with the demands of the job market, education is one of the industries that will be most immediately impacted. Research is required to determine predictability models to anticipate future responses to online learning, optimize the benefits of online learning, and effectively handle the inherent drawbacks from a personal and emotional standpoint.

All authors contributed to the paper. Conceptualization, Seema Irshad; Formal analysis, Seema Irshad; Investigation, Seema Irshad; Methodology, Seema Irshad; Supervision, Osama Al-Saeed; Validation, Osama Al-Saeed, and Nurjahan Begum; Visualization, Nurjahan Begum; Writing – review & editing, Nurjahan Begum.