S1 Appendix -

Background
Protective measures like social distancing and staying home when possible were imposed by the public health authorities to combat the COVID-19 pandemic. Educational institutions which had previously experienced only face-to-face traditional methods of service delivery suffered from huge difficulties in maintaining an effective teaching process. This cross-sectional study investigates the experiences of students of Hawler Medical University (Erbil, Iraqi Kurdistan), exploring their e-learning experience and satisfaction when conventional classroom learning was suspended due to lockdown.
Methods
A self-administered online questionnaire designed on Google Forms was administered from 14 to 31 March 2020. The main section of the questionnaire asked participants to rate their agreement with statements concerning e-learning satisfaction using a five-point Likert scale, with answers ranging from strongly disagree to strongly agree.
Results
From an initial 1550 participants, 808 ultimately completed the processual stage. The majority of respondents were female, from the College of Medicine, of urban residence, and of an average economic situation. Three-quarters of the respondents had not participated in any online course before, 27.7% did not have the required electronic devices, 43.3% did not have the sufficient computer skills for the e-learning, and 38% thought that the University did not support the use of the e-learning system. During the processual stage, only 24.4% thought that the internet connection was good and helpful, 14.6% easily attended the online sessions, 35.6% thought that teachers have enough time to answer students’ questions and concerns, and 18% that the teaching materials contributed to the course objectives and overall learning outcome.
Conclusions
Hawler Medical students were not well prepared to engage in the e-learning process. The majority experienced internet access and other technical problems in accessing the online sessions. They did not feel that the e-learning process has contributed to the achievement of course objectives and overall learning outcomes.