This study employed online Future Problem Solving (FPS) learning and instruction method aided by technology during an online course. FPS allows students to think creatively and imaginatively to address contemporary challenges that might get worsen in the future (Treffinger et al., 2012). This technique includes identifying and researching a future underlying problem, raising possible solutions to the problem, evaluating them according to different criteria, making an informed choice of solution, developing an action plan, and demonstrating how the solution found will work to solve the underlying problem (Cramond, 2009).

A central 21^st-century skill practiced during FPS is digital literacy, defined as the awareness, attitude, and ability of individuals to appropriately use digital tools and “…to identify, access, manage, integrate, evaluate, analyze and synthesize digital resources, construct new knowledge, create media expressions, and communicate with others” (Martin, 2005, pp. 135–136). The current study presents an intervention practice of FPS program and set out to explore its contribution to students’ digital literacy identity in the field of health education. Hence, it focuses attention on eHealth Literacy, succinctly defined as the ability to access medical information from digital sources, evaluate its quality, and apply it in the context of health (Mehoudar, 2014).

Another key issue central to this study is the level of teacher guidance in online courses during the pandemic. Indeed, online courses demand more independent learning, however, many students who participate in such courses experience frustration because they lack the self-directed learning skills required in online courses and are not prepared for isolated learning experiences (Kim et al., 2014). In addition, during the pandemic, studies indicated that students have struggled to manage their studies while dealing with financial and emotional hardships (Nguyen & Balakrishnan, 2020).

Based on these premises, the current quasi-experimental study employed FPS program in two groups of Health students distinguished by the level of teacher guidance: minimal and frequent. It was hypothesized that participants who received frequent assistance from the teacher (research group) would report attaining higher levels of eHealth Literacy skills, following implementation of FPS compared to the onset of the program, than the control group.

Method Participants Data for the analysis were gathered from 3rd-year 113 Israeli undergraduate students of a Health Management program of whom, 62 comprised the research group. Participants were enrolled in two courses dealing with quality in health systems. Both groups (research and control) were taught by the same instructor. Measurements eHEALS scale. This eight-item scale (Norman & Skinner, 2006) was designed to measure students perceived digital skills at using information technology for health. Cronbach’s alphas ranged from .88 to .92. Future Thinking. Based on the theoretical framework, this scale was constructed for the purpose of the current study. This six-item scale corresponds to the six steps of the FPS program (Torrance & Cramond, 2002). Cronbach’s alphas ranged from .86 to .93. Procedure The research and control groups were enrolled in a three-month FPS program, including the following six steps (Cramond, 2009): Step 1. The step included introducing a future broad challenge and breaking it down into a number of challenges. Step 2. Each group selected one problem related to one of their specific challenges and formulated it as a question. Step 3. At this step, each group produced four solutions to the problem formulated in Step 2 and conducted a brainstorming session during which they were instructed to imagine any solution that came to mind, regardless of rationale or feasibility. Step 4. This step included devising criteria to evaluate the solutions they raised. Step 5. Each group evaluated their four solutions according to the criteria using a grid that indicated the quality of each criterion. Step 6. Finally, each group devised a plan to pitch their desired solution. In relation to eHealth Literacy, the research group students were guided by the lectures who provided weekly sessions. These were mainly centered on honing digital eHealth Literacy skills needed to substantiate their solution to the future problem. Students in the control group received an asynchronous session regarding eHealth Literacy and were encouraged to seek the instructor’s feedback via email or zoom meetings, yet synchronous lessons were not scheduled for this purpose due to lack of institutional resources. Data Analysis Analysis of variance was applied to allow the characterization of differences between the pre- and post- interventions within the research and control groups.

Findings To check the hypothesis, a univariate analysis was applied to allow the characterization of differences between the pre- and post- test in each group (research /control) on eHealth Literacy skills. As shown in Figure 1, the analysis showed significant differences between the tests (F(1, 102) = 12.664, p < .01, η2 = .110) for the research group, with increased levels of eHealth Literacy skills detected between the tests (pretest M = 3.44 SD = 0.68; posttest M = 3.90 SD = 0.59). Non-significant results were shown between the tests for the control group (F(1, 92) = 1.993, p > .05, η2 = .021). H1 was corroborated. Conclusions According to the findings, increased levels of eHealth Literacy skills were detected after the intervention in the research group compared to its beginning, whereas non-significant results were shown between the tests for the control group. The findings of this study emphasize the importance of the lecturer’s mediation in the form of guidance while devoting time to the processes of developing eHealth Literacy abilities among students in the health professions. They also emphasize the changes that need to be implemented in the role of academia in medical education. These changes involve training graduates to adapt to the changing environment of the medical world and the demands of the health care system and working world of the 21st century.

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