SACM - United States of America
Permanent URI for this collectionhttps://drepo.sdl.edu.sa/handle/20.500.14154/9668
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Item Restricted UNDERSTANDING THE LIVED EXPERIENCES OF SAUDI ARABIAN INTERNATIONAL STUDENTS IN THE UNITED STATES DURING THE FIRST STRIKE OF THE COVID-19 PANDEMIC: A PHENOMENOLOGICAL STUDY(Oakland University, 2024) Aldaej, Sarah Adel; Smith, JuliaThis research aimed to explore the lived experiences of Saudi Arabian international students studying in the United States during the first strike of the coronavirus (COVID-19) pandemic. Three research questions guided my study: What challenges did Saudi Arabian international students studying in the United States experience at the onset of the COVID-19 pandemic? What type of support or services did the students receive from their institutions or the government? How did the students cope and adjust as the COVID-19 pandemic persisted? This research applied segmented assimilation theory to the students' integration theory and drew on higher education research literature to suggest some indicators that could be employed to study international students' perceptions of their higher education experiences. The aim was to gain a deeper understanding of students' experiences from underrepresented groups better. I employed a qualitative research design to develop an understanding and identify common challenges Saudi Arabian international students experienced during the first strike of the coronavirus pandemic. I collected data from 10 participants by conducting in-depth phenomenological interviews. I developed the interview protocol with a list of semi-structured interview questions prepared in advance and used to guide the interviews. The findings revealed six major themes: (a) Financial impact, (b) Impact on academic life, (c) Institutional communication and support, (d) Impact on social life and social support, (e) Emotional and psychological impact and support, and (f) Strategies for adaptation and persistence. The themes from the participants' experiences revealed intersections with and ties to the scholarly literature. My research developed an understanding of the perspectives expressed by Saudi Arabian international students in the early stages of the COVID-19 pandemic. Understanding the lived experiences of underrepresented groups is crucial for policymakers and regulators, as well as for those developing support initiatives, to effectively serve these populations. The recommendations for future research and professionals provide a clear direction in developing support programs for international students and enhancing the services provided to them, with the aim of promoting their well-being and facilitating their progress.22 0Item Restricted Impact of SARS-CoV-2 Salivary Gland Infection on the Production of the Antifungal Peptide Histatin-5, Candida Colonization, and the oral Microbiota(University of Maryland, Baltimore, 2024) Alfaifi, Areej; Rizk, Mary Ann; Warner, Blake; Schneider, Abraham; Meiller, Timothy; Sultan, AhmedDespite the myriad oral manifestations during COVID-19 and presence of SARS-CoV-2 in saliva, the oral cavity remains an underappreciated site. However recent findings have shown that SARS-CoV-2 can replicate in salivary gland cells, leading to inflammation and tissue destruction. Saliva contains antimicrobial peptides considered integral components of innate immunity crucial for oral health, with the most notable being histatin-5. This peptide is exclusively produced in salivary glands and exhibits unique potent antifungal activity against Candida albicans. In this dissertation, we discovered that destruction of salivary gland by SARS-CoV-2 can compromise histatin-5 production, predisposing patients to oral candidiasis and dysbiosis in the oral microbiome. First, we utilized our novel customized immunoassay to measure salivary histatin-5 levels in a prospective study involving stratified COVID-19 cohorts. Our data indicates a trend showing a decrease in salivary histatin-5 and increase in Candida during COVID-19, persisting post-COVID-19 recovery, potentially contributing to the long COVID-19 syndrome. To provide lacking mechanistic insights into the pathophysiology of salivary gland dysfunction during COVID-19, we performed in situ hybridization coupled with immunofluorescence to co-localize SARS-C0V-2 and histatin-5, respectively, in salivary gland tissue from deceased COVID-19 patients. Our findings indicated diminished or absent histatin presence in salivary gland acini with proliferating SARS-CoV-2 providing the first direct evidence associating SARS-CoV-2 with histatin-5 production. Next, we conducted a comprehensive metagenomic analysis on clinical oral samples and identified potential COVID-19 associated pathologic dysbiotic shifts in the oral microbiome. Lastly, we conducted in-vitro experiments coupled with scanning electron microscopy and confocal imaging to identify the effect of histatin-5 on candida cells and biofilm concluding the antifungal effect of histatin-5 on candida albicans. This clinical study clearly shows the effect of SARS-CoV-2 on oral microbiota, highlighting the importance of understanding and managing the complex dynamics within the oral cavity of COVID-19 patients.15 0Item Restricted Perceptions of School Leaders about Digital Communication in the Saudi Education System(Tennessee State University, 2024-05) Alshahrani, Nasser M.; Gundi, KirmanjThe purpose of this study was to determine the perceptions of school leaders in Bisha about digital communication in the Saudi education system. The purpose of the current study was also to identify the attitudes of school leaders towards digital communication in terms of factors affecting the acceptance and use of digital communication in the educational process, and to identify the extent of performance and the expected benefit from the use of digital communication systems by school leaders in the Saudi educational system. This study also attempted to test the impact of some factors, such as ease of use, perceived usefulness, and behavioral intention in the actual use of digital communication technologies, and to reveal the obstacles facing school leaders in the Saudi education system while using digital communication technologies, and their suggestions for developing the use of these technologies in the educational process. One of the key findings of the study is that the presence of high levels of satisfaction among school leaders in the Saudi education system with the use of digital communication. They emphasized the importance of focusing on training courses to enhance the technical capabilities of school leaders, teachers, and students. Importantly, the study revealed that there were no statistically significant differences based on educational qualifications, leadership experience, or participation in training courses, indicating a consistent trend of positive attitudes toward digital communication among school leaders.7 0Item Restricted Developing Novel Antiviral Agents: Targeting the N-Terminal Domain of SARS-CoV-2 Nucleocapsid Protein with Small Molecule Inhibitors(Virginia Commonwealth University, 2024-05-13) Alkhairi, Mona A.; Safo, Martin K.The COVID-19 pandemic, caused by SARS-CoV-2, persists globally with over 7 million deaths and 774 million infections. Urgent research is needed to understand virus behavior, especially considering the limited availability of approved medications. Despite vaccination efforts, the virus continues to pose a significant threat, highlighting the need for innovative approaches to combat it. The SARS-CoV-2 nucleocapsid protein (NP) emerges as a crucial target due to its role in viral replication and pathogenesis. The SARS-CoV-2 NP, essential for various stages of the viral life cycle, including genomic replication, virion assembly, and evasion of host immune defenses, comprises three critical domains: the N-terminal domain (NTD), C-terminal domain (CTD), and the central linker region (LKR). Notably, the NTD is characterized by a conserved electropositive pocket, which is crucial for viral RNA binding during packaging stages. This highlights the multifunctionality of the nucleocapsid protein and its potential as a therapeutic target due to its essential roles and conserved features across diverse pathogenic coronavirus species. Our collaborators previously initiated an intriguing drug repurposing screen, identifying certain β-lactam antibiotics as potential SARS-CoV-2 NP-NTD protein inhibitors in vitro. The current study employed ensemble of computational methodologies, biophysical, biochemical and X-ray crystallographic studies to discover novel chemotype hits against NP-NTD. Utilizing a combination of traditional molecular docking tools such as AutoDock Vina, alongside AI-enhanced techniques including Gnina and DiffDock for enhanced performance, eleven structurally diverse hit compounds predicted to target the SARS-CoV-2 NP-NTD were identified from the virtual screening (VS) studies. The hits include MY1, MY2, MY3, MY4, NP6, NP7, NP1, NP2, NP3, NP4 and NP5, which demonstrated favorable binding orientations and affinity scores. Additionally, one supplementary compound provided by Dr. Cen’s laboratory (denoted as CE) was assessed in parallel. These hits were further evaluated for their in vitro activity using various biophysical and biochemical techniques including differential scanning fluorimetry (DSF), microscale thermophoresis (MST), fluorescence polarization (FP), and electrophoretic mobility shift assay (EMSA). DSF revealed native NTD had a baseline thermal melting temperature (Tm) of 43.82°C. The compounds NP3, NP6 and NP7 notably increased the Tm by 2.55°C, 2.47°C and 2.93°C respectively, indicating strong thermal stabilization over the native protein. In contrast, NP4 and NP5 only achieved marginal Tm increases. MST studies showed NP1, NP3, and NP7 exhibited the strongest affinity with low micromolar dissociation constants (KD) of 0.32 μM, 0.57 μM, and 0.87 μM, respectively, significantly outperforming the control compounds PJ34 and Suramin, with dissociation constants of 8.35 μM and 5.24 μM, respectively. Although NP2, NP6, and CE showed relatively weaker affinity, these compounds still demonstrated better binding affinities with dissociation constants of 4.1 μM, 2.50 μM, and 1.81 μM, respectively than the control compounds PJ34 and Suramin. These results substantiate the potential of these scaffolds as modulators of NTD activity. In FP competition assays, NP1 and NP3 exhibited the lowest half-maximal inhibitory concentrations (IC50) of 5.18 μM and 5.66 μM, respectively, indicating the highest potency at disrupting the NTD-ssRNA complex among the compounds, outperforming the positive controls PJ34 and Suramin, with IC50 of 21.72 μM and 17.03 μM, respectively. The compounds NP6, NP7, CE, and NP2 also showed significant IC50 values that ranged from 7.00 μM to 10.13 μM. EMSA studies confirmed the NTD-ssRNA complex disruptive abilities of the compounds, with NP1 and NP3 as the most potent with IC50 of 2.70 μM and 3.31 μM, respectively. These values compare to IC50 of 8.64 μM and 3.61 μM of the positive controls PJ34 and Suramin, respectively. NP7, CE, NP6, and NP2 also showed IC50 ranging from 4.31 μM to 7.61 μM. The use of full-length nucleocapsid protein also showed that NP1 and NP3 disrupted the NP-ssRNA binding with IC50 of 1.67 μM and 1.95 μM, which was better than Suramin with IC50 of 3.24 μM. These consistent results from both FP and EMSA highlight the superior effectiveness of NP1 and NP3 in disrupting nucleocapsid protein-ssRNA binding, showcasing their potential as particularly powerful antiviral agents. Extensive crystallization trials were conducted to elucidate the atomic structures of SARS-CoV-2 NP-NTD in complex with selected hit compounds, assessing over 8000 unique crystallization conditions. Ultimately, only a PJ34-bound structure could be determined, albeit with weak ligand density, likely due to tight crystal packing impeding binding site access. The crystal structure was determined to 2.2 Å by molecular replacement using the published apo NP-NTD (PDB 7CDZ) coordinates as a search model, and refined to R-factors of 0.193 (Rwork) and 0.234 (Rfree). The refined NP-NTD structure showed conserved intermolecular interactions with PJ34 at the RNA binding pocket as observed in the previously reported HCoV-OC43 NP-NTD-PJ34 complex (PDB 4KXJ). This multi-faceted drug discovery endeavor, combining computational screening and in vitro assays resulted in successful identification of novel compounds inhibiting the SARS-CoV-2 nucleocapsid N-terminal domain. Biophysical and biochemical studies established compounds NP1 and NP3 as superior hits with low micromolar binding affinities, as well as low micromolar potency superior to standard inhibitors at disrupting both isolated N-NTD-RNA and full-length nucleocapsid-RNA complex formation. Though crystallographic efforts encountered challenges, important validation was achieved through a resolved crystal structure of PJ34 in complex with NP-NTD. Future effort will be to obtain co-crystals of NP-NTD with our compounds to allow for targeted structure modification to improve on the potency of the compounds.6 0Item Restricted THE ROLE OF MASSIVE OPEN ONLINE COURSES (MOOCs) IN TEACHER PROFESSIONAL DEVELOPMENT DURING COVID-19: A SYSTEMATIC REVIEW(University of North Texas, 2024) Alqarawy, Meshael Abdulrahman S.; Spector, Jonathan MichaelThe systematic review in this study focuses on questionnaire-based quantitative and qualitative studies that focus on the role of massive open online courses (MOOCs) in teacher professional development, with a concentration on the COVID-19 lockdown period. Sixteen studies were selected to be included in this systematic review based on the inclusion and exclusion criteria. The study was designed to answer four main questions: (a) how have MOOCs been used in teacher professional development during the COVID-19 crisis? (b) what are teachers’ perspectives toward using MOOCs for professional development? (c) what teacher skills reported as critical in those studies can be improved using MOOCs? and (d) what challenges faced by teachers during the use of MOOCs for training are reported in those studies? The results of this review reveal that (i) MOOCs were used to support teachers moving online, improve their personal skills during that crisis, and allow them to meet teachers in different areas and share their experience through online camps; (ii) teachers viewed a set of positive and negative aspects of the available MOOCs, and they addressed some criticisms of the available MOOCs and factors that may impact the success of MOOCs; (iii) MOOCs during the COVID-19 pandemic focused on developing three types of skills in teachers: online teaching skills, personal skills, and specialization skills; and (iv) financial and technical challenges, the quality of the available MOOC content, and the lack of time combined with their duties during that time are the most critical challenges teacher faced.23 0Item Restricted Developing Antiviral Drugs for COVID-19 and Hepatitis C: Targeting Key Viral Proteases(Virginia Commonwealth University, 2024-05-14) AlAwadh, Mohammed; Safo, Martin K.Viruses are submicroscopic infectious agents causing immense global disease burdens. Propagation of viral particles relies on proteolytic cleavage of polyprotein precursors by host or virally-encoded proteases to liberate functional components necessary for replication and infection cycles. These processing events present vulnerable intervention points for antiviral targeting. This thesis focused on two indispensable viral proteases - the SARS-CoV-2 main protease and the NS3 protease domain from hepatitis C virus. The first project centered on the discovery of small molecule inhibitors against the SARS-CoV-2 main protease (Mpro). As a cysteine protease, Mpro plays an indispensable role in processing the virally-encoded replicase polyproteins through specific cleavages to liberate functional non-structural proteins that regulate virion maturation and assembly pathways. Owing to such critical involvement, Mpro offered an attractive target for coronavirus pathogenesis intervention. Its near-identical architecture with the SARS-CoV strain enabled rapid knowledge transfer for drug design using prior scaffolds. Therefore, an ensemble small molecule discovery platform consolidating computational screening, synthetic chemistry, enzymology and biophysical characterization was constructed to systematically retrieve inhibitors against this important drug target. Three virtual screening protocols using complementary in silico techniques – ligand-based 3D pharmacophore searches, protein structure-centric molecular docking, and artificial intelligence models employed deep neural networks. This triaged computational workflow efficiently narrowed a search space of millions to selectively cherry pick prospective hit candidates. In parallel, quantitative structure-activity examinations of a small, focused library of 168 synthetically derived α-ketoamide compounds revealed a reactive Michael acceptor warhead amenable for covalently targeting the key catalytic cysteine residue. Downstream characterization in a tiered cascade of biochemical and biophysical techniques validated the tandem computational-experimental screening approach. Fluorescence resonance energy transfer (FRET) enzyme assays confirmed dose-dependent SARS CoV-2 Mpro inhibition for 10 ligands – 7 from virtual screening pipelines and 3 α-ketoamide derivatives – with low micromolar half maximal inhibitory concentrations between 1.7-55 μM. Direct binding quantification via label-free biophysical methods like microscale thermophoresis and isothermal titration calorimetry supplemented functional data. The tightest-binder, compound MA4, achieved a binding affinity of around 5 μM. Attempts to co-crystallize Mpro with ligands for atomic perspectives encountered technical limitations likely owing to poor aqueous solubility, nevertheless yielding 1.8 Å resolution apo-enzyme insight into plasticity elements lining the substrate binding cleft. Microsecond timescale explicit-solvent molecular dynamics simulations tracked long-term dynamic stabilities of inhibitor-bound complexes, corroborated through rigorously computed binding free energy predictions. Lastly, objective hit enrichment and success rate metrics evaluated relative virtual screening performances, demonstrating superior early retrieval rates for the deep learning technique that leveraged biochemical data patterns. The second collaborative project expanded targeting scope beyond conventionally exploited catalytic sites to explore an allosteric regulatory protein-protein interface on the hepatitis C NS3 protease domain. NS3 requires binding of a co-factor NS4A peptide to achieve sufficient catalytic activity essential for mediating downstream viral polyprotein processing events linked to replication competency. NS4A triggers key structural rearrangements in otherwise natively disordered NS3 that enable organization of the catalytic triad into a configuration competent for catalyzing substrates. This activation paradigm presented possibilities for blocking the interaction site with engineered variants retaining affinity but subtly distorting functional geometries through strategic mutations. Results validated this, revealing a designed nanomolar-binding NS4A variant with a single cyclohexylglycine substitution that associated with NS3 but eliminated enzyme activity. Microscale thermophoresis quantifications revealed PEP15 associated with the NS3 protease domain target with remarkably high, low nanomolar binding affinity exhibiting a dissociation constant (KD) of 22.23 ± 0.297 nM. This was approximately two orders of magnitude stronger binding compared to the native NS4A cofactor peptide, which achieved a KD of 2.595 ± 0.0015 μM in the same assay configuration. The exceptionally improved affinity despite a single residue substitution substantiates the significant energetics contributions of the engineered glycine mutation and validates the allosteric targeting rationale underlying the inhibitor design. Differential scanning fluorimetry indicated unexpected reductions in thermal stability relative to native complex or isolated protein controls. Metadynamics simulations provided insights into the unexpected biophysical findings by modeling dynamics and stability of the PEP15-NS3 complex. The trajectories revealed favorable occupying of the deep hydrophobic environment lining the NS3 allosteric pocket by the engineered glycine substitution. Notably, the modelling also captured shifting of the key SER139 hydroxyl moiety away from the organized catalytic triad geometric center. Displacement of this nucleophilic residue plausibly misaligns other proximal components due to intricate hydrogen bonding networks. Structural rearrangement of active site elements likely contributes to the abolished enzymatic activity despite high affinity binding of the strategic PEP15 peptide.33 0Item Restricted Advancing Emergency Department Efficiency, Infectious Disease Management at Mass Gatherings, and Self-Efficacy Through Data Science and Dynamic Modeling(Virginia Polytechnic Institute and State University, 2024-02-27) Ba-Aoum, Mohammed; Hosseinichimeh, Niyousha; Triantis, KonstantinosThis dissertation employs management systems engineering principles, data science, and industrial systems engineering techniques to address pressing challenges in emergency department (ED) efficiency, infectious disease management at mass gatherings, and student self-efficacy. It is structured into three essays, each contributing to a distinct domain of research, and utilizes industrial and systems engineering approaches to provide data-driven insights and recommend solutions. The first essay used data analytics and regression analysis to understand how patient length of stay (LOS) in EDs could be influenced by multi-level variables integrating patient, service, and organizational factors. The findings suggested that specific demographic variables, the complexity of service provided, and staff-related variables significantly impacted LOS, offering guidance for operational improvements and better resource allocation. The second essay utilized system dynamics simulations to develop a modified SEIR model for modeling infectious diseases during mass gatherings and assessing the effectiveness of commonly implemented policies. The results demonstrated the significant collective impact of interventions such as visitor limits, vaccination mandates, and mask wearing, emphasizing their role in preventing health crises. The third essay applied machine learning methods to predict student self-efficacy in Muslim societies, revealing the importance of socio-emotional traits, cognitive abilities, and regulatory competencies. It provided a basis for identifying students with varying levels of self-efficacy and developing tailored strategies to enhance their academic and personal success. Collectively, these essays underscore the value of data-driven and evidence-based decision- making. The dissertation’s broader impact lies in its contribution to optimizing healthcare operations, informing public health policy, and shaping educational strategies to be more culturally sensitive and psychologically informed. It provides a roadmap for future research and practical applications across the healthcare, public health, and education sectors, fostering advancements that could significantly benefit society.27 0Item Restricted Biofunctionalization of Micro/Nanoparticles for Neutralizing SARS-CoV-2 Surrogate and Targeting ACE2-expressing Lung Cells(Saudi Digital Library, 2024) Alkhaldi, Soha; Peng, Ching-AnThe SARS-CoV-2 virus, which led to the COVID-19 pandemic, first emerged in China in the end of 2019 and swiftly propagated to affect the entire world. COVID-19 has caused millions of illnesses and deaths worldwide. The illness from virus infection may lead to acute respiratory distress syndrome (ARDS), necessitating hospitalization in intensive care units and the use of mechanical ventilators for some individuals. Efforts to mitigate the effects of the pandemic have depended heavily on measures like vaccination drives and public health strategies such as the use of masks and maintaining physical distance to curb the virus's transmission. The emergence of SARS-CoV-2 variants has raised concerns due to their increased ability to spread, their potential to lead to more severe illness, and their reduced responsiveness to existing treatments and vaccines. Preventing viral nanoparticles from entering susceptible lung cells is an approach to curb the transmission of SARS-CoV-2 and any future related coronaviruses. In this study, two strategies were harnessed to achieve the goal – (i) blocking SARS- CoV-2 spike proteins on the outer surface of virions, and (ii) blocking recombinant human angiotensin- converting enzyme 2 (hACE2) receptors on the targeting lung cells. Micro/nanoparticles (biotinylated fluorescent polystyrene particles and perfluorooctyl bromide (PFOB)-based oxygen nanoemulsions) tethered with the recombinant hACE2 were designed and fabricated for the neutralization of spike protein pseudotyped lentivirus (employed as SARS-CoV-2 surrogate). For blocking the hACE2 receptors on the target cells, biotinylated fluorescent polystyrene particles tethered with the recombinant receptor-binding domain (RBD) to saturate hACE2 receptors, thereby preventing the SARS-CoV-2 surrogate from infecting cells. Furthermore, since mesenchymal stem cell-derived extracellular vesicles (MSC-derived EVs) have been proven to possess therapeutic potential for repairing lung injuries, an innovative method for the separation of MSC-derived EVs was developed using chitin magnetic microparticles bound with chitin-binding domain (CBD) fusion with self- cleaving intein tag and lactadherin C1C2, which has a high affinity to phosphatidylserine (PS) exposed on EV membranes. As a result, purified MSC-derived EVs tethered with RBD of SARS-CoV-2 spike protein and loaded with small interfering RNA (siRNA) green fluorescent protein (GFP) could specifically target hACE2 receptors on GFP-expressing A549 lung adenocarcinoma cells and dramatically diminish the level of GFP expressed in the cells.27 0Item Restricted Dentists' Education, Knowledge, Attitudes and Behavior concerning the Effects of Pregnant Patients' Oral Health on Pregnancy Outcomes: A National Survey(Saudi Digital Library, 2021-12-08) Khuraybah, Abad; Boynton, James; Majewski, Robert; Salzmann, Larry; Inglehar, Inglehart; Inglehart, Marita RObjectives: Since 1996, there is empirical evidence that pregnant patients’ oral health and pregnancy outcomes are related. The objectives were to assess general dentists’ education, knowledge and professional behavior related to treating pregnant patients’ oral health and how COVID -19 affected dentists’ professional behavior related to the relationship between oral health and pregnancy outcomes Methods: 2,500 surveys were mailed to members of the American Dental Association; 96 were undeliverable and 253 were completed (Response rate: 10.52%). Results: About half of the respondents (50.2%) agreed/strongly agreed that they were well educated about treating pregnant patients in dental school. However, only about a third (34%) were satisfied with this education. The majority knew that periodontal disease was associated with preterm delivery (71.8%) and infants’ birth weight (69.3%), and that pregnant patients can safely undergo basic dental treatment (90%), tooth extractions (82.8%) and root canal treatment (90.3%). The majority delivered fillings (78.4%), periodontal treatment (69.2%) and root canal therapy (66.2%) to pregnant patients. Nearly all dentists delivered routine examinations and cleanings (94%) to these patients and discussed the importance of oral health during pregnancy (91.6%). A total of 38.6% was concerned about legal risks and 38.6% believed there were no guidelines for treating pregnant patients. COVID did not change treatment patterns for the majority of respondents. The better their dental school education was, the more knowledge they had about pregnant patients’ oral health care (r=0.19;p<0.001) and the more likely they were to deliver this care (r=0.30;p<0.001). Conclusions: Increasing educational efforts in dental school and continuing education about the effects of pregnant patients’ oral health on pregnancy outcomes is needed to improve related knowledge and professional behavior.30 0Item Restricted Respiratory Therapy Students’ Perception on Online Learning During COVID-19 in the Kingdom of Saudi Arabia(Saudi Digital Library, 2023-11-17) Alshehri, Faisal; Goodfellow, LyndaBACKGROUND: In response to the COVID-19 pandemic, electronic learning (E-learning) has emerged as the primary method for delivering educational materials, particularly within the scope of Saudi Arabian (SA) Respiratory Therapy (RT) education. PURPOSE: To evaluate the perception of E-learning among RT students in the Kingdom of Saudi Arabia (KSA) by comparing face-to-face learning to E-learning during the COVID-19 pandemic. METHODS: A cross-sectional survey to investigate the perception of E-learning was conducted and distributed using a convenience sample of RT students through an online platform (Google Forms) between September and November 2023. RESULTS: Overall, 221 RT students, with females accounting for 119 (53.8%), replied to the online survey. The study revealed several advantages of E-learning, including the ability to study at home (67.9%), access to online materials (64.7%), and learning at own pace (62.4%). The main disadvantages as indicated by most respondents were the lack of interactions with patients (70.1%), technical problems (56.6%), and reduced interaction with teachers (50.7%). No significant difference in the perceptions of knowledge enhancement between face-to-face and E-learning methods (P = .32). However, E-learning was considered a lower effective method than face-to-face learning for both clinical skill development (P < .001), and social competencies (P < .001). Additionally, respondents reported that they were less actively engaged during E-learning classes compared to face-to-face classes (P < .001). Nonetheless, a significant percentage of respondents (71.9%) claimed that E-learning was an enjoyable experience. CONCLUSION: This research emphasizes the potency of E-learning in terms of increasing knowledge as a valuable tool for educating Saudi RT students. Nevertheless, it highlights the need for a meticulously planned strategy and a proactive implementation approach to effectively implement clinical and social skills E-learning into the educational framework of RT students.34 0