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This study aims to explore whether online learning has an effect on communication between instructors and students in a negative way, whether online learning affects students' productivity levels and to evaluate and suggest ways of improving effective online communication between instructors and students.

This study used is a quantitative research study which was conducted through a semi-structured online survey through a random sample technique.

Results revealed that the vast majority agree with the questions of the study. Students still prefer classroom classes over online classes due to many problems they face when taking online classes, such as lack of motivation, understanding of the material, decrease in communication levels between the students and their instructors and their feeling of isolation caused by online classes.

This research studied the impact from students' perspective only as the sample was selected only from students.

This research reached the students’ point of view in a broader way which will help understanding the issues and provide effective solutions. This research suggested that instructors must communicate with their students and vice versa in more informal channels (instant messages online chat groups, audio calls, private video calls …) in parallel with the formal channels (online platforms, email …). Finally, instructors should encourage students to participate and study more by providing different kind of incentives.

The purpose of this study had two aims: (1) to extend insight regarding the challenges of implementing standardised work, via care pathways, in a healthcare setting by considering interactions with other operational (i.e. resource sharing, portfolio alignment) and professional (i.e. autonomous expertise) dependencies and (2) to develop novel insights regarding a specific flow mechanism, the stroke nurse practitioner, a form of flow “pilo” or guide.

This was a longitudinal case study of implementing the acute stroke care pathway in a National Health Service hospital in England based on 185 hours of non-participant observations and 68 semi-structured interviews. Archival documents were also analysed.

The combined flow, operational and professional dependency lens extends operations management understanding of the challenge of implementing standardised work in healthcare. One observed practice, the process pilot role, may be particularly valuable in dealing with these dependencies but it requires specific design and continuous support, for which the authors provide some initial guidance.

The research was a single case study and was focussed on a single care pathway. The findings require replication and extension but offer a novel set of insights into the implications of standardised work in healthcare.

In addition to confirming that a multidependency lens adds conceptual and practical insight to the challenges of implementing standardised work in a healthcare setting, the findings and recommendations regarding flow “pilots” are novel. The authors' analysis of this role reveals new insights regarding the need for continued improvisation in standardised work.