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This study addresses this need by designing and validating a comprehensive questionnaire (ELFEQ) to assess these factors across both face-to-face (F2F) and e-learning environments in medical education. A quantitative, cross-sectional study was conducted with 298 students from Shiraz University of Medical Sciences (SUMS), Iran. Data were collected using the researcher-developed 27-item ELFEQ questionnaire (rated on a 5-point Likert scale). Exploratory Factor Analysis (EFA) with Varimax rotation was used for initial factor extraction, and Confirmatory Factor Analysis (CFA) was subsequently performed. Reliability was assessed using Cronbach\u2019s alpha. Data analysis was performed using SPSS Version 24. The analysis revealed six primary factors influencing student learning experiences, including Peer Interaction, Teacher-Student Interaction, Examination and Assessment methods, Emotional Comfort, Content Quality, and Assignments. The highest factor loading was observed for peer interaction and collaborative learning. The questionnaire accounted for approximately 70% of the ELFEQ construct, with a reliability coefficient of \u03b1\u2009=\u20090.933. The Content Validity Index (CVI) was 0.976, and the Content Validity Ratio (CVR) was 0.898. The Kaiser-Meyer-Olkin (KMO) measure yielded a value of 0.920, indicating excellent sampling adequacy, while Bartlett\u2019s Test of Sphericity was significant (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.001), confirming the suitability of the data for factor analysis. The findings suggest that effective educational practices must integrate diverse teaching methods and assessment strategies to accommodate various learning styles. Both F2F and online environments offer unique advantages that can be leveraged through a blended approach. The study underscores the importance of creating inclusive and supportive learning environments that prioritize student comfort and engagement, ultimately enhancing educational outcomes.\n                  <\/jats:p>","DOI":"10.1038\/s41598-026-58815-1","type":"journal-article","created":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T14:15:18Z","timestamp":1781878518000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Medical students\u2019 perceptions of learning modalities: development and psychometric validation of the e-learning and face-to-face learning experience questionnaire"],"prefix":"10.1038","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5631-6448","authenticated-orcid":false,"given":"Zahra","family":"Karimian","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Navab","family":"Momeni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6606-2795","authenticated-orcid":false,"given":"Hamid","family":"Mohammadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3319-2048","authenticated-orcid":false,"given":"Maryam","family":"Jalali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,19]]},"reference":[{"issue":"21","key":"58815_CR1","doi-asserted-by":"publisher","first-page":"2131","DOI":"10.1001\/jama.2020.5227","volume":"323","author":"S Rose","year":"2020","unstructured":"Rose, S. 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