The COVID-19 pandemic accelerated digital transformations that required adjustments in occupational settings and training among medical teams, especially among nurses, who constitute the most prominent healthcare workforce. This period was marked by the mass adoption by healthcare providers worldwide of digital technologies and technology-based virtual platforms (i.e., telehealth and telenursing) aimed at prevention and monitoring. Consequently, the COVID-19 pandemic has set a new standard of care for nurses and has changed their workforce roles (Bell & Brysiewicz, 2020). An open question in the field is whether the increased use of remote technologies due to the COVID-19 pandemic has changed nurses’ attitudes toward telenursing.

A subset of telehealth, telenursing denotes the delivery, management, and coordination of care and services using telecommunication technologies by nurses (Glinkowski et al., 2013). Telenursing requires new professional, methodological, personal, and social nursing skills and competencies. For example, care delivery through audio calls requires greater interviewing competency, as nurses lose the possibility of using visual assessment for decision-making (Fincher et al., 2009). Hence, it is worthwhile for nurses to learn and practice the fundamentals of remote communication with patients. Telenursing began with the advent of the telephone, as nurses handled healthcare questions over the phone. Over the last decade, telenursing services have expanded beyond phone triage to videoconferencing. However, its implementation has raised concerns regarding costs and lack of safety, efficacy, and cost-effectiveness data. Moreover, providing telenursing treatments without training has been shown to cause discomfort to both the nurse and the patient (Chan & Hjelm, 2001; Rutledge & Gustin, 2021). Thus, there is an evident need to prepare nurses for the new global challenges and demands of the digital technology-based virtual healthcare provision (Bell & Brysiewicz, 2020; Kumara & Sudusinghe, 2021).

Nursing education has recently experienced substantial changes, primarily due to the COVID-19 pandemic. The ease of accessing low-cost resources, coupled with real-time connectivity, has made videoconferencing a preferred method for delivering virtual education to students and clinicians. Many healthcare institutions have had to quickly adapt to these new communication modalities, often with limited preparation (Jeffries, 2022).

During the COVID-19 pandemic, the shift to online learning was initially seen as a constraint, but it also presented valuable education opportunities. There has been a notable shift towards student-centered approaches in nursing studies, with curricula emphasizing simulations and distance learning (Leong et al., 2022; Lokmic-Tomkins et al., 2022; Purnell et al., 2020). Moreover, training in this field has also moved online, with mobile device-based education demonstrating significant improvements in students’ learning motivation, self-confidence, communication competency, and perceived usefulness (Shanmugapriya et al., 2023). As we progress, it is essential to consider whether it is worth continuing to embrace these technological advancements even after the pandemic. However, despite digital technology's great advantages, barriers to using it for learning among nursing students still exist. Students and teachers alike still do not take full advantage of these platforms’ potential and have difficulty and poor confidence in using them. Therefore, digital literacy-targeted educational interventions need to be an integral part of foundational nursing studies, as they will improve nursing students’ baseline digital literacy before commencing clinical placement (Lokmic-Tomkins et al., 2022;Loureiro et al., 2021).

Nurses’ acceptance of new technology based on behavioral models holds significant importance, as their views are closely linked to performance and can directly impact clinical outcomes and patient satisfaction (Ajzen, 2020; Taherdoost, 2019). The theory of planned behavior (TPB) and the technology acceptance model (TAM) are commonly used to assess the factors that contribute to the acceptance of new technologies. According to TAM, the motivation for users’ acceptance is explained by a number of factors, including (1) the degree to which a person believes that using a particular system would enhance his or her job performance (perceived usefulness, PU); (2) the degree to which a person believes that using a particular system would be free of effort (perceived ease of use, PEOU); and (3) an individual's positive or negative feelings (evaluative affect) about using the technology (attitude toward use, AT) (Venkatesh et al., 2003). According to the TPB model, users’ technology acceptance depends on a number of predictors, including (1) the perceived social pressures from important others encouraging them to perform the behavior (subjective norms, SN); (2) the person's perceived ease or difficulty in performing the behavior (perceived behavioral control, PBC) (Venkatesh et al., 2003); and (3) the likelihood that a person will overcome potential obstacles (self-efficacy) (Ajzen, 2020).

Previous studies demonstrated that healthcare workers, specifically nurses, intention to use a given technology was best predicted by the perceived ease of use, perceived social influence, and perceived usefulness for patient care (Holden et al., 2012; Hung et al., 2014). Also, training and Management support were found to be the most significant factors affecting the perceived ease of use and perceived usefulness (Barzekar et al., 2019). Previous studies also found that nurses’ attitudes towards telenursing correlated positively with their intention to participate in telenursing, with more positive attitudes expressed by nurses who were already using the technology or who perceived the technology to be simple and easy to use (Bashir & Bastola, 2018; Chang et al., 2021; Hu et al., 1999; Napitupulu et al., 2021; Rho et al., 2014; Saigi-Rubió et al., 2016).

To the best of our knowledge, previous studies concerning perceptions toward adopting telenursing technologies did not compare the attitudes of nurses who underwent frontal training before COVID-19 with those of nurses who trained online during or after COVID-19. Hence, the aim of this study was: (1) to explore behavioral-related factors based on both TAM and TPB for predicting the intention to use telenursing through videoconferencing and (2) to compare attitudes of nurses that undertook frontal (before COVID-19) vs. online (during and after COVID-19) postbasic nursing courses. Of note, Israeli nursing practice is multistaged: the first stage is of academic study track for a bachelor's degree in nursing. This stage lasts 4 years and is conducted in universities and colleges. These studies are followed by a government licensing exam. In the second stage, registered nurses (RNs) with a BA, can choose to specialize in a clinical track and undergo a postbasic education. Postbasic education is an advanced, highly regarded certificate that provides further training and expertise in specific areas of nursing practice. This training aims to enhance nurses’ skills and knowledge in specialized fields, allowing them to deliver advanced care to patients with specific healthcare needs (Brodsky & Van Dijk, 2008). Examples of postbasic education for nurses include specialized certifications in critical care nursing, and pediatric nursing.