During the COVID-19 pandemic post-secondary courses transitioned from in-person to online learning environments, which came with challenges but also created opportunities to modify teaching and learning approaches that could continue upon the return to in-person learning. The purpose of this study was to determine the effect of students’ ability to self-select their preferred learning environment/lecture format [online, in-person or hybrid (combined in-person and online learning)] on academic performance, overall stress, academic stress, learning approach (deep and surface learning approaches), and to gain insight into students’ perceptions of online learning. During the Winter 2022 semester, courses were delivered online for the first 4 weeks, before the removal of COVID-19 restrictions. For the remaining 8 weeks, students in a fourth-year chronic disease pathophysiology course (n=210) were given the option to self-select their preferred learning environment/lecture format for the remaining 8 weeks of the semester, choosing between in-person (n=56, 26.7%), online (n=113, 53.8%), or hybrid (n=41, 19.5%) learning. Final grade and perceived stress levels did not differ between lecture formats; however, stress levels were inversely associated with final grades in the online (r = -0.19; P=0.02) and in-person (r = -0.41; P=0.05) lecture formats with no association in the hybrid format (r = 0.03; P=0.85). Further, academic stress was identified as the greatest source of stress experienced by 64% of in-person, 76% of hybrid, and 69% of online students. Students preferred learning requirements aligned with their self-selected learning format, wherein the main online learning challenges included i) needing more clarification, ii) difficulty interacting with professors, iii) feeling more distracted, iv) having lower comprehension, and v) experiencing difficulty with time management (P<0.05). These findings demonstrate that students’ learning environment preferences influence their choice of lecture format; however, even when a preferred learning environment is selected, students’ academic stress levels remain high and influence academic performance.
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