Change from face-to-face teaching and learning to online learning: A case of a cross-sectional study in a Kazakhstani medical University

Abstract The widespread development of modern technologies, particularly the internet, has triggered an explosive growth of distance learning. Due to the COVID-19 pandemic, moving to distance learning platforms to continue education has become necessary. Kazakhstan’s radical teaching and learning mode change from face-to-face to online has brought challenges and opportunities. The main aim of this study was to examine how lecturers and students at a Kazakhstani medical university adapt and cope with the online teaching and learning mode to suggest a sustainable model for online learning. A cross-sectional survey was administered with 40 third- and seventh-year students and 40 lecturers at a selected medical university in Kazakhstan to assess the participants’ distance-learning experiences. Complexity theory was adopted as the lens to interpret the findings to understand how the change in teaching and learning mode impacted lectures and students, how they adapted to the online learning environments, and how they cope with conditions of uncertainty. The study’s findings show that, although the transition to the distance mode of teaching and learning was a forced reality for educational institutions due to the quarantine measures, most respondents preferred distance learning to the traditional face-to-face mode, albeit with challenges. We further identified the challenges and opportunities encountered. The study findings would have far-reaching implications on change management, teaching practices, learning practices, and the university’s teaching and learning policy and strategy concerning online/distance learning sustainability going forward.


Introduction
Like all others from different parts of the world, higher education practitioners in Kazakhstan are looking for innovative and updated teaching and learning methodologies to maximise their education results.In this quest, using technologies to enhance teaching and learning emerged.There has been a gradual move and transition from face-to-face teaching and learning to online or blended methods.In 2000, Kirillova (2000) predicted that Kazakhstan would need to increase the possibilities of providing education on a distance basis due to the increase in student numbers due to the demand for higher education brought about by new social and economic reforms.
It was not long before the COVID-19 pandemic affected all countries.In 2019, Kazakhstan, like all other countries, was forced to develop measures to provide education at a distance or online.The COVID-19 pandemic accelerated the need for online learning at various institutions of higher learning.This situation became a new reality among Kazakhstan's higher education institutions (HEIs).The transition from the face-to-face mode of teaching and learning involves many changes and presents many challenges and opportunities.The process of moving towards online/distance teaching and learning happened amidst the adoption of the Digital Kazakhstan State Program for 2018-2022, which aims to enhance the use of ICT in all sectors of the economy to improve efficiency and productivity (Kazakhstan, 2017).Although accelerated by the pandemic, implementing online/distance teaching and learning was part of Kazakhstani's digitisation policy.As a result, the transition towards online learning would fulfil two goals, i.e. compliance with the government policy of digital Kazakhstan and the delivery of curriculum amidst the COVID-19 pandemic.
However, as Burakanova et al. (2021) state, the advent of the pandemic exposed the non-readiness of the relevant state bodies when institutions transitioned from face-to-face to distance or online mode.Institutions of higher learning were compelled to develop measures to make this possible.For instance, according to the UNESCO chair on Water Resources Management in Central Asia at Kazakh-German University (DKU) (2021) reporting on the case of Kazakh-German University in Almaty, the university was confronted with the challenge of transition to distance learning.This report indicates that the university needs to do a situation analysis, develop strategic planning mechanisms, and implement a comprehensive strategy to deal with the transition to distance/online education.Several challenges were identified in the process, i.e. internet access for students, availability of modern technologies and the readiness of instructors to apply these technologies in class.The transition to a distance/online mode of education affected the performance management of instructors, the digitalisation of institutional operations, and the identification and application of new digital teaching and learning methodologies.Durrani et al. (2021) identify challenges of distance education during the start of the COVID-19 pandemic.In their study, they articulate that during this time, the following emerged: widening of education disparities between the urban and rural institutions; problems associated with student distance learning such as plagiarism (directly taking education material from the internet and not acknowledging it correctly); well-being of students as a result of lack of support due to absence of support by the institutional communities; the inability of students to maintain work-life balance; and student psychological and physical well-being as a result of work overload.In summary, digital technology posed challenges as there were no training and policy guidelines (Bokayev et al., 2021).Challenges such as internet connectivity limited the interactive and communicative learning relationships.There was a general decline in student outcomes, and lecturers could not assess the impact of their teaching and student learning.However, conversely, according to Selikhan et al. ( 2022), the pandemic allowed the government and institutions to reimagine their digital and technological strategies.The context and introductory orientation described above led to the formulation of the purpose of this study.

Purpose statement
This study, therefore, explored the experiences of lecturers and students at a medical university in Kazakhstan to identify the challenges and opportunities as they moved to the online mode of teaching and learning, investigate the implications for change and make recommendations about the sustainability of online learning going forward.In order to achieve this goal, this study sought to answer the following research question(s): • How did lecturers and students experience a transition from face-to-face to online learning?
• What benefits/opportunities and challenges are presented by online learning?
• How can online learning be improved?Moreover, what measures are needed to make learning sustainable through online learning?
• How can the complexity theory of change help understand the impact of change from face-to-face to online learning?Furthermore, what should institutions do to manage change towards online education going forward?
The answers to these questions have far-reaching implications for institutional change strategies, teaching practices, and the university's online teaching and learning policy and strategy.Therefore, analysing lecturers and student experiences, this paper contributes significantly to the scientific literature and knowledge about change and transition from face-to-face to online teaching and learning and how online learning could be made more effective and sustainable even during times of crisis and sudden disruptions.

Conceptualising online learning and teaching
The OECD (2020, p. 5) defines e-learning, online learning, and distance learning as similar in character and nature.These concepts are often used interchangeably, referring to using online-based digital material to support learning.Online learning only sometimes occurs at a distance; it can also be used in physical classrooms to complement traditional teaching methods, i.e. blended learning (Pearcy, 2009).On the other hand, Esani (2010, p. 187) conceptualises online education as an approach that connects lecturers and students with resources, virtual communication and remote activities, using a learning management system (LMS) as the primary means of instruction.Esani (2010) further indicates that online learning creates a "social presence" that is critical, as it builds a community of belonging that may impact students' cognitive learning and positively impact student learning.
For Dhawan (2020), online education is an umbrella concept: online learning, open learning, web learning, computer-mediated learning, blended learning, and m-learning refer to using online technology and offering an alternative space where learning takes place.Online learning is conserved as student-centred and interactive, as it allows two-way engagements through instant conversations and feedback.In this study, online learning is understood to mean learning conducted online but off campus, and this concept is used interchangeably with distance learning because, during the COVID-19 pandemic, students learned online at a distance (meaning off campus).

The challenges and opportunities of online learning
Online learning and teaching present opportunities for change and adaptation.Godber and Atkins (2021) postulate that the transition to online/distance teaching and learning prompted lecturers to reflect critically upon their teaching and learning strategies and, as a result, presented them with the opportunity to grow professionally.Oyedotom (2020) identifies that critical challenges include a lack of resources, poor national digital infrastructure, course delivery issues, student flexibility, lack of technical assistance, and cybersecurity concerns.Elfirdoussi et al. (2020) have also found that not all students and lecturers favor working online due to its challenges and complexities.Problems associated with online learning may include technical issues, the usability of gadgets, and the participants' and lecturers' skills.Butnaru et al. (2021) assert that students' proficiency in using online tools, their ability to access online courses technically, and the lecturers' way of conducting learning activities are all crucial for student online/distance learning success.According to Gherhes et al. (2021), the maturity of students may impact their willingness to choose online/distance learning, i.e. first-year students might experience more challenges than their seniors in transitioning to online/distance learning.According to Zalat et al. (2021), this challenge may also apply to earlycareer lecturers who are still grappling with the challenges of their inexperienced academic life.Xu and Jaggars (2013) contend that the transition from face-to-face to online learning may lead to students and lecturers finding it hard to adapt to online learning, which may impact lecturer and student performances.While it is believed that students' performance online may be as good as in a face-to-face environment, Pearcy (2009) avers that students' overall satisfaction regarding online learning is positive.Still, the general performances of students are better when taught on a face-to-face basis.This view is also echoed by El Said and Mandl (2021).On the other hand, although students still do well, it is interesting that Almendingen et al. (2021) report that students experience lower motivation to learn when changing to online/distance mode, perhaps because more intrinsic motivation is needed to maintain the learning momentum.
Because of student motivation and insufficient online learning challenges, some suggest using a blended mode, combining online and face-to-face learning.For instance, Watson (2008) avers that blended learning allows students to experience the advantages of both face-to-face and online learning.Conversely, Kemp and Grieve (2014) postulate that despite online learning offering similar academic performances and more flexibilities, students still lean towards face-to-face learning.
The success of online/distance teaching and learning depends on several factors.According to Elumalai et al. (2020), the quality of e-learning is influenced by factors such as administrative support, course content, course design, lecturer characteristics, learner characteristics, social support, and technical support.One of the significant aspects is how online/distance teaching and learning are organised.For instance, in their work, Khalil et al. (2020) found that if it is well synchronised, online learning is readily applied to medical students.Furthermore, in the study to examine the motivational factors for students to learn online, Maheshwari (2021) states that the perceived enjoyment of using the online platform, enhanced by ICT infrastructure and usability, as well as institutional support, is critical in enhancing student online intentions.
In assessing the significance of online learning, Nguyen (2015) avers that online learning is as good as face-to-face learning, but lecturers must embrace it first.Mpungose (2020) postulates that online learning may be hindered by equity and access issues, especially in a technologically disadvantaged community.According to Nwankwo (2015), constant and consistent reviews of online courses and programs could ensure the effectiveness of online learning.Rapanta et al. (2020) postulates that the assessment strategies must be adapted to the online/distance mode to respond to students' educational needs to minimise the impact on student performances.
According to Durrani et al. (2023), in the Kazakhstani context, the digital divide was more disadvantageous to lecturers and students despite government and institutional efforts to provide online technological equipment.Institutions that are highly resourced fared well compared to those under-resourced.

Sustainability and online learning
The pandemic caused a disruption that forced every institution of higher learning to use online learning.However, while these institutions took measures to address the situation by providing digital equipment and training lecturers on online tools, there is a view that more was needed to ensure sustainability.To ensure the sustainability of digital pedagogy Hansen et al. (2021) postulate that post-Covid 19 institutions need to integrate the Sustainable Development Goals (SDGs) within the higher education curriculum.Other authors such as Hueske et al. (2022) advocate that MOOCs might be helpful as a platform to cover DSGs 9 (Industry, Innovation, and Infrastructure),13 (Climate Action),11 (Sustainable Cities and Communities), and 16 (Peace, Justice, and Strong Institutions).This view is echoed by Crawford and Cifuentes-Faura (2022).There is also a view that institutions have to develop well-being plans for both lecturers and students to ensure sustainable support (Faura-Martínez et al., 2022).Furthermore, Cifuentes-Faura et al. (2021), like Durrani et al. (2023), Solas-Pilio et al. (2021) aver that the improvement of internet connectivity might be able to bridge the gap between rural and urban digital and societal divide.Other sustainable measures include the training of students to use technology in ways that could minimise student anxiety.There is also an emphasis on creating an inclusive environment that sustains student interaction with fellow students and lecturers e.g.video conferencing (Faura-Martínez et al., 2022) and the use of social media (Alismaiel et al., 2022).
As the change to online/distance teaching and learning presented its challenges, it is essential to understand the experiences of role players and the change process.Therefore, the complexity theory is discussed concerning how it provided an integrated analysis of the change process and offers plausible implications for institutions moving to online teaching and learning.Fullan (1999, p. 36, in Makoelle, 2011, p. 72) distinguishes between two approaches to educational change: the complexity approach and the evolutionary approach.The complexity approach is a more interactive approach towards change whereby stakeholders interact to bring stability.By contrast, the evolutionary approach assumes that change will happen over time.

Complexity change theory
Complexity theory is regarded as a framework that departs from the underlying assumption that components of an organisation are interdependent and that any change to the organisation has to happen spontaneously and in all components of an organisation.The complexity theory critiques linear change theory because of the interwoven nature of the organisational components.Cunningham (2004, p. 32) provides a helpful summary of the critical elements of the complexity theory.According to Cunningham, systems which lend themselves to a complexity analysis: • are dynamic; that is, they are continuously changing.
• are far from equilibrium, have the potential to change suddenly and may take one of two paths (bifurcate).
• are open systems; that is, interchange energy (and information) with their surroundings • involve feedback.What happens next depends on what happened previously.
• are systems where the whole is more than the sum of the parts.
This implies that organisational change is fluid, and patterns emerging from the organisational system may not be predictable.The organisation purports to be dynamic and ever-changing but also adaptive to new emerging effects of agents as they apply agency.Makoelle (2011), quoting Mittler (2000, p. 134) about the complexity approach, postulates that change is an ongoing process.Everyone involved should continually monitor and reflect on the process to implement change successfully.The view is echoed by McCallion (1998), Loreman et al. (2005).Makoelle (2011), borrowing from Goodson (2003), avers that those involved in change should continually challenge their beliefs and notions about the process of change.Similarly, Haney et al. (2002) argue that beliefs, attitudes, knowledge and understanding are pivotal points to be looked at closely if any success is to be registered.According to Makoelle (2011, p. 74), the complexity approach to change is congruent with the notion of collaboration advanced by Mohr et al. (2004), Richardson (1998), Somekh (2006), and Ainscow et al. (2006).This notion is crucial for the successful implementation of change as those for whom change is intended collaborate to improve their practice.To bring about the desired results, reflection is crucial for educational change, challenging the status quo and introducing new ideas (Briscoe, 1996;Fullan & Hargreaves, 2005;Hoban, 2002;McTaggard, 1997).
Collaboration with the organization will develop into what Fullan (2001) calls a professional learning community.The community allows stakeholders to learn together in what will be referred to as a community of practice (Fullan, 2001;Hargreaves, 1997;Wenger, 1998).A community of practice should probe its practices to improve them (Reason & Bradbury, 2006;Retallick et al., 1999).

Methodology
A cross-sectional survey, featuring four (2-3) biographical information questions (for faculty: professional level, experience in years and gender) (for students: level of study and gender), eleven (11) closed Likert scale questions and three (3) open-ended questions, was administered through a google forms platform to a randomly selected group of university lecturers and students to assess the participants' distance learning experiences.It is purposeful in that only students and lecturers engaged in distance/online learning would provide rich data.Both students and lecturers constituted 50% of medical courses and 50% of non-medical courses.In this study, online learning was conducted in two ways: distance online is when lecturers conduct teaching and learning using online platforms, while distance offline is when lecturers do not conduct classes but send learning material to students for self or independent study.The survey questions were harvested from the research questions.The survey was validated by conducting a pilot with a representative sample of 20% of the total study sample before being administered for data collection.This cross-sectional survey was conducted among the third-and seventh-year students (40 participants) and 40 lecturers (80 participants) of a selected medical university in Kazakhstan.The response rate was high, as 77 of the 80 surveys were returned completed.In the first part of the questionnaire, the closed questions were posed whereby lecturers and students had to answer questions rating them on a Likert scale (1 to 4):

Survey scale rating
The second part of the questionnaire posed the following open-ended questions to lecturers and students: • What are your experiences of the change and transition from face-to-face to online/distance mode of teaching and learning?
• What benefits/opportunities and challenges are presented by the change to online/distance learning?
• What could be done to improve online/distance learning?Moreover, how can it be sustained?

Data analysis
Descriptive statistics were used to analyse the survey data.In all eleven survey questions, items are compared according to the percentage of frequency registered with the participants.
The analysis of open-ended questions and answers was done using content analysis.The process started with reading data, determining the frequency of words, themes, or concepts, finding relationships to build categories and meanings, and finally synthesising conclusions (Bengtsson, 2016).The statistical and qualitative data were then compared to derive the study findings.To interpret the implications of the findings concerning the change process from face-to-face to online learning, the complexity theory was then used as a lens to interpret the findings.Complexity theory was adopted in this study to understand the adaptive impact of how change by university teaching and learning mode influence how participants adapt to their environments and how they cope with conditions of uncertainty as a result (As shown in Table 1 below).Data were analysed based on the complex theoretical framework to understand how participants adapt and cope with the change in the mode of teaching and learning.
The different components of Cunningham's (2004) complexity theory were used to analyse the impact of the transition of face-to-face teaching and learning by lecturers and students.

Ethical considerations
Both lecturers and students were told the purpose of the study.They were assured that participation was voluntary and that they could withdraw from the study at any point.The informed consent was sent to them to fill in and sign.They were informed about their rights and the procedures regarding anonymity and confidentiality.More specifically, the names of participating departments were not mentioned anywhere.Participants' identities were concealed by replacing names with numbers/letters, e.g.Participant 1/Participant B), and the information they provided was kept on the researcher's computer, which is secured with a password.An assurance was given that the information provided by the participants would be used for research purposes only.

Findings
The findings are presented with descriptive statistical data and the responses from lecturers and students.First, the findings concerning the three questions are provided below: • How do you experience the transition from face-to-face to online learning?
• What benefits/opportunities or challenges are presented by online learning?
• How can online learning be improved and sustained going forward?
Second, the interpretation of findings through the complexity theory is done to determine the impact of the change from face-to-face to online learning.

Online/Distance learning versus traditional education
Due to the quarantine measures, the massive transition to distance learning has become a new reality for most educational institutions.However, the survey questionnaire results analysis has

Elements of Complexity Theory
How elements were used to interpret findings Institutions are dynamic; that is, they are continuously changing.
How institutions of higher learning as organisations change continuously.
Are far from equilibrium, have the potential to change suddenly and may take one of two paths (bifurcate).
The impact of a sudden change from face-to-face to online/distance learning.
Are open systems, that is interchange energy (and information) with their surroundings.
The influence on interaction, and communication by both students and lecturers.
Involve feedback.What happens next depends on what happened previously.
The review of the education process and the use of feedback for adaptation to the new approach.
Are systems where the whole is more than the sum of the parts.
How the interdependence of organisational sections impacts change.
Are causal and yet indeterminate.
That change is dependent on some factors, i.e. lecturer and student agency.Strategy and policies: Institutions to embark on strategic planning to manage disruptions and crises and develop policy guidelines 2 Far from equilibrium, it has the potential to change suddenly and may take one of two paths (bifurcate).

How
The impact of a sudden change from face-to-face to online/ distance learning.First, while change may be planned, a sudden change may present an opportunity for an alternative.In the case of this study, lecturers and students were forced to explore the alternatives.Second, the study showed that although Kazakhstan institutions were on course to develop technology for learning, the process was not adequately planned and thus impacted the well-being of students and lecturers.The review of the education process and the use of feedback for adaptation to the new approach.The study indicates that the continual reflection and review of the educational process is essential for improving online/ distance teaching and learning strategies.The study shows it was difficult for lecturers to account for the education process properly.Durrani et al. (2023) highlight the significance of policy and clear guidelines for online assessment procedures and principles.

Pedagogy:
The review and reflections on the educative process and assessment are crucial for consistency and sustainability in line with DSGs.
5 Systems where the whole is more than the sum of the parts.
How the interdependence of organisational sections impacts change.Change towards online/distance means that the ecosystem has to change, i.e. the institutional environment, culture, and practices-the conditions at home and surroundings.Because of the absence of a coherent strategy on environmental conditions on part of the university, online learning was not sustained.Casanova et al. (2018) postulate that to sustain online learning drawing from Maslow's hierarchy of needs, the basic, institutional, and stakeholder motivations are crucial as they may promote institutional strategy and enhance ownership and innovation by lecturers and students.
Environment: in line with the DSGs, configure the institutional environment, culture and practices of online teaching and learning 6 Causal, yet indeterminate.That change is dependent on some factors, i.e. lecturer and student agency.Transitioning from face-to-face to online/distance teaching and learning requires both lecturer and student agency to influence the educational process.In this study, collaboration was critical for the success of online learning.Han et al. (2021) postulate that enhancing student voices, their visual functionality, and emotional engagement through working with and through others ensures the sustainability of online learning.

Agency and Skills:
Institutions must create a conducive environment and structures for stakeholder engagements to assess skills development and support needs.
shown that most lecturers and students prefer distance learning to the face-to-face (traditional) one (Figure 1).
The data show that lecturers and students preferred online/distance instead of face-to-face teaching.Most classes were conducted using online platforms such as Zoom and WebEx.Alternatively, lecturers sent tasks via digital files such as Word documents.60% of students and 70% of lecturers surveyed preferred distance online education.However, the lecturers lamented that the swift change to distance/online mode of teaching and learning was too quick, and they were not prepared for the sudden change; this direct answer by one of the lecturers to an openended question attests to this, My experience with the change was wrong; I was unprepared to change my teaching from face-to-face to online.A lot of emergency preparation was needed.
Lecturers indicated that although they worked hard to adapt to the new way of facilitating teaching and learning, there was less guidance and they had to refine both their professional skills and competencies.For instance, one of the lecturers averred, I had to undergo some reskilling in order to be able to transition smoothly to online teaching.

Graph showing a statistical comparison between the preference for distance online and distance offline education by lecturers and students
The lecturers indicated that their reflective discussions with colleagues helped them rethink their teaching and learning strategies to embrace online/distance learning.As a result, working collaboratively was vital in their transition to the distance/online teaching mode.The following phrase by one of the lecturers supports this, … the fact that we worked cooperatively as colleagues to one another in tackling the challenges of changing our teaching and learning strategy was beneficial.

Distance online versus distance offline
Distance online is when lecturers conduct teaching and learning using online platforms, while distance offline is when lecturers do not conduct classes but send learning material to students for self or independent study.Preference between the two is depicted and described below in figure 2: The study has shown that the lecturers experienced distance online more positively than students did.When asked about their preference for distance online learning, most lecturers indicated that distance/online teaching and learning provided at least some contact and interaction with students and created a hybrid for online and virtual interaction.The following extract from the lecturer's response is evidence, I prefer that even when we teach and facilitate student learning from a distance, we keep engaged with the students through some online platform to check what they are doing or making progress.
The students, on the other hand, showed a preference for distance offline mode.Asked about their preference for distance offline, students were more inclined to believe it allowed them to learn at their own pace and style.However, because they were expected to work independently in a distance offline mode, students lamented the lack of guidance, sufficient support, and, in some instances, a lack of understanding of the learning material.Lecturers mentioned that they cannot provide pastoral care for students and this presented a well-being challenge, and it was difficult to conduct student assessments from a distance.
The results concerning the preferences for the platform used in distance education have been distributed, as shown in Figure 3.The given bar chart illustrates that for lecturers, the best platform is WebEx.None of the lecturers chose Google Classroom, Edu-Mark, or Skype.On the contrary, according to students' opinions, the best platforms for distance education were Microsoft Teams and Zoom.Both students and lecturers indicated that their choices were informed by the "userfriendliness" of the platform.
Various factors influenced the choice of an online platform.For the students, the best platforms for distance learning were Microsoft Teams and Zoom.The result was that the preferences in choosing a platform have turned out to be different.Perhaps, other than the user-friendliness, this is because the platform addressed the needs and requirements of a particular user.
The focus of lecturers' attention during online classes seems to be influenced by their aim: presenting material in an accessible way, monitoring students, and having the ability to facilitate high-quality knowledge transmission to students.This was one of the reasons some platforms were preferred to others, as they provided this opportunity.However, students and lecturers asked about their familiarity with the platforms, and most lamented insufficient skills and knowledge.

Benefits of online/distance learning
As shown in figure 4 above, the study shows that lecturers and students seem to think that when they are online and not bound to a teaching and learning location, they seem to have more time for other professional activities.In one form or another, most teachers consider the release of free time the main advantage.70% of lecturers versus 30% believed online teaching and learning gave them more time.However, it was expected that during the distance learning period, teachers would spend more time preparing electronic materials, mastering additional platforms, etc.This is likely because higher educational lecturers were not bound to a workplace so that they could use all the available time.This is evident because most lecturers indicated they did not observe working hours but worked at home whenever they got time throughout the day.The following quote from the lecturers' responses seems to imply this, I am amazed by the fact that I can work throughout the day, at my own pace and still achieve my daily professional goals.
The graph shows the statistical percentages of different benefit factors of distance learning to students (learning at home, more free time, learning at a convenient time, self-study opportunities, no contact with COVID-19 patients) Students were also asked to enumerate the advantages of distance/online learning.Distance education has given them essential benefits such as the opportunity to study at home, which provides learning at a convenient time and having more free time (Figure 5).It also became evident from the study that most students regarded the outstanding advantages of online learning as information availability, as presented in Figure 6 below.
When asking about how they found information for their studies, most students indicated that they were forced to work independently and were thus forced to visit different databases for their assignments.Thus, this information search process forced them to look beyond the material that the lecturers presented.The following extract from one of the student's responses indicates this.
Working online, rather independently allowed me to explore the different avenue where I could get information, this let me to many places and thus I was exposed to a lot of information relevant for my studies.

Challenges of online/distance learning
At the same time, online/distance education has several disadvantages and difficulties.Its most essential drawbacks from the lecturers seem to be the lack of contact with students, which caused the most significant discomfort for lecturers.The lack of control over classes, along with the internet/technical problems, limited distance teaching as well (Figure 7).Among the technical difficulties, the lecturers noted low internet speed, lack of internet access, platform connection problems, and no licences for taking full advantage of some platforms.The following extract from the lecturers' responses seems to confirm these issues, I think online learning is exemplary, but occasionally, one needs to interact with students; otherwise, some may be left behind in their work because it is difficult to gauge their progress when they are at a distance.
The most significant disadvantage of distance education, according to the students, was poor internet connectivity (35%).Meanwhile, 20% of students believed that distance learning had no weaknesses.
Furthermore, the study showed that 60% of students noted difficulties when studying learning materials without a teacher.Students are less independent in understanding educational material, unlike students whose current education system is aimed at their self-study.Figure 8 and 9 below Presents the disadvantages of distance learning.
The analysis of open-ended question which asked students and lecturers about how online learning could be improved or sustained.Five aspects were prioritised.This is a list of what they thought was necessary (in no order of importance): Planning and digital learning strategy by the institution; Methodological training and workshops for lecturers; Curriculum guide and assessment strategy; Pastoral care and well-being; Updated technological infrastructure.

Discussion of findings
First, findings are discussed to how well they address the research questions: • How do you experience the transition from face-to-face to online learning?
• What benefits/opportunities or challenges are presented by online learning?
• How can online learning be improved and sustained going forward?Second, the interpretation of findings through the complexity theory is done to determine the impact of the change from face-to-face to online learning.

Experiences of lecturers and students
The study has confirmed that lecturers and students preferred the online/distance mode of teaching and learning at a medical university.However, it is clear from the study results that the sudden change was disruptive, and lecturers and students were supposed to enhance their skills in response to the change towards the application of online/distance modes of teaching and learning (Xu & Jaggars, 2013).This view is consistent with that of Faura-Martínez et al. (2022) who contend that familiarity with technology might be helpful in minimising student anxiety.It is evident that when lecturers collaborate and reflect on their practices, the disruption caused by the sudden change in teaching and learning strategy is minimised.However, the fact that students and lecturers were able to embrace change indicates the fluidity of the institutions of higher learning and the nature of the educative process (Nguyen, 2015).It is also evident that the change was not sustained due to a lack of appropriate policies and guidelines for online learning (Durrani et al., 2023).

Benefits of online/distance learning
Despite the benefits of online/distance learning, the study has shown that it can also work well when combined with some face-to-face interaction between lecturers and students in a hybrid form to mitigate the disadvantage of lack of interaction between lecturers and students (Maheshwari, 2021;Pearcy, 2009).Online/distance has been confirmed by this study as studentcentred and provides the necessary freedom for students' independent learning, which is critical for students' cognitive, intellectual and academic development (Dhawan, 2020).
The study has shown that the usability of online platforms, their usefulness for the content being studied and the ability of lecturers and students to use them were critical in the choices the lecturers and students made regarding their application as the teaching and learning platforms (Elumalai et al., 2020).
It is evident from the study that online/distance teaching and learning led to the reorganisation of lecturer and students' time planning and scheduling.It seems as though this was needed in order to free up some time for teaching and learning activities.The study indicated that proper planning of online/distance is crucial for its success (Khalil et al., 2020) The study has shown that online/distance teaching and learning force students to work independently and, as a result, they learn through discovery and thus are exposed to information they never encountered.As a result, learning becomes student-centred, and students can learn at their own pace and style.

Challenges of online/distance learning
It is evident from the study that disparities in terms of resources may impact on how well online/ distance teaching and learning could be successful (Mpungose, 2020).The technical infrastructure, such as the internet, seems to be very prominent in the success of the education process.While students can study independently, the study has demonstrated that lecturers' guidance is still fundamental to student learning (Oyedotom, 2020).To deal with online/distance learning chal-  lenges, the study shows constant reflection and review of the education process were needed (Nwankwo, 2015).

Implications for the improvement and sustainability of online learning
Based on the study's findings, the experiences of lecturers and students regarding sustainable online learning seem to be based on the model with five key cardinal pillars (as depicted in the figure 10 below:

Strategy and policies
The disruptive nature of the transition from face-to-face to online/distance teaching and learning requires that institutions of higher learning implement contingency plans to deal with the eventuality of change.The results of this study show that although the university provided the necessary equipment and some support, it could be prudent to provide policy guidelines and training for online learning to both students and faculty.This view is echoed by Faura-Martínez et al. (2022).As a result, incorporating DSGs into the curriculum and teaching and learning strategies will go a long way in sustaining the achievement of digital pedagogy (Cifuentes-Faura & Noguera-Méndez, 2023;Durrani et al., 2023).

Well-being and support
While students and lecturers were left alone to work it out regarding teaching and learning, it is evident that well-being needs to be prioritised.As Faura-Martínez et al. ( 2022) aver, measures have to be taken to alleviate student anxiety, and this can happen if an appropriate supportive virtual environment is provided.On the same note, Salas-Pilco et al. ( 2022) state that emotional support during the lonely learning space is crucial.In this study, it was evident that moments when lecturers met with students, albeit briefly, provided emotional support, which sustained their learning momentum.The conditions that promote the well-being of students and lecturers are essential for sustained online learning (Durrani et al., 2021).

Agency and skills
In order to have sustainable online teaching and learning, the environment should enable both students and the lecturer's agency.According to Li et al. (2021), the agency is enabled by providing emotional, cognitive and behavioural student engagements.In this study, lecturers and students' insufficient resources and skills constrained their agency.Therefore, it suffices to recommend training and upskilling of both lecturers and students regarding the use of various online platforms and guiding students on independent work (Salas-Pilco et al., 2022).

Pedagogy
It is evident that online learning benefits from interactiveness and connectivity between role players.In this study, while online/distance teaching and learning appeared more effective than face-to-face teaching and learning, it could be seen that, in some instances, combining both enhances the much-needed contact between lecturers and students.As a result, the sustainability of online learning pedagogy seems to rely mostly on forming communities of learning.For instance, as Alismaiel et al. (2022) suggest, social media enhances connective pedagogy.This view is supported by Chu et al. (2021), who state that interactions between students enhance and enrich their online learning experiences.

Environment
In this study, it became evident that collaboration was key for the support and sustainability of online learning (Ionescu et al., 2020).It is, therefore, important that institutions encourage lecturers to collaborate and form communities of practice and review strategies to improve the online/distance teaching and learning educational process.Improving technical infrastructure and bridging the digital divide may go a long way toward improving the effectiveness of the online/ distance teaching and learning approach at medical universities in Kazakhstan (Durrani et al., 2023).

Implications for sustainable change
For institutions to be able to manage change from face-to-face teaching and learning, several considerations based on the findings of this study are evident.In the last column of the table below, recommendations connected to the cardinal pillars of online sustainability, as identified in this study, are made regarding the promotion of smooth transition:

Complexity theory: lessons for change management
Using complexity theory as a lens, the following interpretation of the result emanated from the data analysis as shown in table 2 below:

Conclusion
While this study has demonstrated the experiences of lecturers and students regarding the transition from face-to-face to online/distance teaching and learning, also highlighting some benefits and challenges of the change process itself and that of the online/distance mode of teaching and learning, it must be borne in mind that the state of the pandemic has discontinued, the conditions and circumstances in institutions of higher learning are still changing constantly.Furthermore, the limitation of the study is that the study was conducted in only one medical school, and maybe working on this study in several institutions might provide a broader and deeper picture.It could also be interesting to compare the experiences of students and lecturers at other medical institutions as well as different types of institutions.
Therefore, this study, while contributing to understanding the experiences of lectures and students in transitioning to an online/distance approach to teaching and learning which makes a fundamental basis for further exploration of online learning, the results should be looked at within the frame of a changing higher education context of Kazakhstan as it transitions away from its post-soviet legacy.
that the dynamic nature of institutions of higher learning creates conditions for continuous change.As a result, the transition from face-toface to online distance occurs within a changing context.In this study, institutions were found unprepared for change toward online learning.As Salas-Pilco et al. (2022) put it, higher education has to transform to create a conducive environment for change.Several measures are suggested, such as ensuring high internet connectivity.

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Figure 4. for teaching and learning.

Figure 5 .
Figure 5. Benefits of distance learning for students.
Figure 6.Benefits of distance learning for students.

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Figure 7. Disadvantages of diseducation for lecturers.

Figure 10 .
Figure 10.Cardinal pillars of online learning Sustainability.

Figure 9 .
Figure 9. Disadvantages of distance learning for students.