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Table of Contents
MEDICAL EDUCATION
Year : 2019  |  Volume : 5  |  Issue : 1  |  Page : 24-27

Understanding the patterns of technology and internet use for academics by undergraduate medical students in a teaching hospital of North India


Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India

Date of Web Publication4-Jul-2019

Correspondence Address:
Sumit Malhotra
Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi - 110 029
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/IJCFM.IJCFM_8_19

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  Abstract 

Background: E-learning or computer-based learning has been incorporated into medical education in many countries. Readiness to utilize this medium merits exploration in the Indian context. Therefore, we aimed at assessing the current patterns of technology and internet use by undergraduate medical students in a tertiary care teaching hospital, focusing on their use for academics and their views on e-learning.
Materials and Methods: This cross-sectional study was conducted using a self-administered questionnaire among undergraduate medical students in the first 4 years of the study. The data generated were entered into Microsoft Excel and analyzed using SPSS version 22. Descriptive analysis and comparison of proportions were done using Chi-square test.
Results: A total of 212 students responded, with a mean (±standard deviation) age of 20 years (±1.54) and 70.3% of males. There was universal access to technological devices with complete internet access. Internet was used primarily for entertainment (99.1%) and WhatsApp (97.2%), with 86.8% use in academics. Most students accessed the internet multiple times each day. Majority of the students (90.6%) used social networking sites and were open to using it for academics. Reliability of the material found online was a concern (83.5%), and most (63.2%) were interested in further training. Only a quarter of the students had utilized medical e-learning material online, and a majority (77.4%) were willing to incorporate it into the curriculum feeling that it would benefit them (64.6%).
Conclusions: Incorporating e-learning tools into the medical curriculum needs to be considered for undergraduate medical studies, owing to its availability and readiness for utilization.

Keywords: E-learning, internet, medical education, technology, undergraduate students


How to cite this article:
Mohan S, Malhotra S. Understanding the patterns of technology and internet use for academics by undergraduate medical students in a teaching hospital of North India. Indian J Community Fam Med 2019;5:24-7

How to cite this URL:
Mohan S, Malhotra S. Understanding the patterns of technology and internet use for academics by undergraduate medical students in a teaching hospital of North India. Indian J Community Fam Med [serial online] 2019 [cited 2019 Jul 20];5:24-7. Available from: http://www.ijcfm.org/text.asp?2019/5/1/24/262126


  Introduction Top


Technological advancement has brought forth a new generation of medical students, who are adept at using computers for various different activities and are in need of structured training in its most effective use in medical care. The landscape of medical education has been evolving rapidly to include new modalities of instruction, such as e-learning or computer-based learning to cater to these young minds. Such tools have been incorporated into the medical curriculum in many countries.[1],[2]

E-learning refers to any form of web-based or computer-assisted learning with the use of videos and multimedia to convey nuances in the subject matter easily.[3] Currently, many formal courses can be accessed online referred to as Massive Open Online Courses, available free of cost, offering training in diverse subjects including medicine.[4] Such courses can be incorporated into the curriculum or emulated to specially target the Indian medical student.

Multiple studies have been done to assess the usage of computers and the internet by medical students around the world[1],[2],[5],[6],[7],[8],[9] and in India.[10],[11],[12],[13],[14] The studies have varied results. Some studies show a low level of access to internet,[1],[5],[10] while a few showed that academic use of Internet was low.[1],[10],[12] Some have looked into the students' interest in incorporating e-learning into the medical curriculum, showing mainly positive attitudes.[1],[5],[12] Only one study looked at the accessibility of mobile internet by Indian medical students.[11]

Against this background, we aimed at assessing the current patterns of technology and internet use by undergraduate medical students in a tertiary care teaching hospital, focusing on their use for academics. In addition, their views on e-learning were assessed to explore the possibility of introducing such novel teaching methods to complement the existing system.


  Materials and Methods Top


This cross-sectional study was conducted during May and June 2016, after acquiring ethics clearance from the institutional review board of the All India Institute of Medical Sciences (AIIMS), New Delhi (Ref. No. IECPG/285-27.04.2016).

Consent was taken before participation, and data were collected using a pretested, self-administered questionnaire in English, prepared specifically for the purpose of the study by the authors. All undergraduate medical students in the first 4 years of study (approximately 288) enrolled at AIIMS, New Delhi, were approached to participate. The questions covered student demographics, their access to technology, knowledge and use of online academic resources, awareness of e-learning modalities, and receptivity to incorporate the same into the curriculum. The data were entered into Microsoft Office Excel 2007 and analyzed using SPSS version 22 (IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp). Relevant proportions were compared using the Chi-square test. Students in the first 2 years of MBBS were taken as one group of “juniors in preclinical years,” and the 3rd- and 4th-year students were taken to be in the “senior group in their clinical years.” A significant difference was judged from a P < 0.05.


  Results Top


A total of 212 of 288 students responded (73.6%), with an average age of 20 years (±1.5 years, range: 17–27) and 70.3% were males. There were 58 1st-year (27.3%), 55 2nd-year (26%), 36 3rd-year (17%), and 63 4th-year (29.7%) students. There was universal access to technological devices, with most students owning a smart phone (98.6%) and a laptop (93.4%). All the students had access to the internet. It was used primarily for entertainment (99.1%) and WhatsApp messaging (97.2%), with 86.8% use in academics. Most students (96.2%) accessed the internet multiple times each day. Majority of the students (90.6%) used social networking sites and 74.5% were open to using it for academics.

The perceived advantages of using the internet for academics were for its quick access (93.4%), ease of search (84.4%), material being up to date (50.9%), and accuracy of information (20.3%), with only 1.4% stating that they saw no advantages. The major limitation to using the internet was due to doubts regarding authenticity of information (83.5%), with others being slow speed (25%), lack of resources (18.4%), ineffective use of the internet by students (18.4%), and lack of time (9.9%). 5.2% stated that they saw no limitations.

Only one half of the students believed that they had adequate skills to search for reliable academic material online. The students in the clinical years were more comfortable with a significant difference noted (60.6% vs. 44.2% P = 0.02). Only a quarter of the students stated that they were aware of how to access academic articles using the institute library's database, with seniors being significantly more capable (32.3% vs. 20.4%, P = 0.047). Wikipedia was the most visited website (92.5%) for reference, with two-thirds students visiting PubMed or Medscape. There was a significant difference noted for the utilization of Medscape by students in the clinical years (3rd- and 4th-year students) as compared to students in the basic science years (1st- and 2nd-year students) (94.9% vs. 46.9%, P = 0.000). Only 16.5% of students used up to date (an evidence-based, physician-authored online clinical decision support resource), with seniors using it more than juniors (26.3% vs. 9%, P < 0.001).

Training in the usage of statistical software in research was demanded by 74.1%, with seniors feeling the need significantly more than juniors (85.9% vs. 63.7%, P < 0.001), and two-thirds of students felt the need for training to access reliable academic content online.

Only a quarter of the students had utilized medical e-learning material online although a majority (77.4%) were willing to incorporate it into the curriculum feeling it would benefit them (64.6%). [Figure 1] depicts the perceived advantages of e-learning with easy access to materials (86.3%) and interactive learning modes (72.6%) being quoted the most. [Figure 2] shows the perceived disadvantages to e-learning, with two-thirds showing concern over the loss of the personal student–teacher interaction.
Figure 1: Advantages of e-learning

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Figure 2: Limitations of e-learning

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  Discussion Top


This was a rapid assessment undertaken to explore technological mediums for undergraduate medical teaching in the North Indian setting. There was universal access to internet-enabled devices among our participants. Only the studies conducted in Akola, Maharashtra, India,[11] and in Iran[9] showed over 95% use of computers and the internet. The older studies in India generally showed about two-thirds students having access to computers and the internet.[10],[11],[12],[13],[14]

Interestingly, our students reported accessing the internet multiple times daily; however, internet was accessed <3 h/week in the studies from Mangalore in 2008, (80%),[12] Meerut in 2012 (77.2%),[10] and Sri Lanka in 2012 (40.2%),[7] while a third of students from Iran[9] in 2014 reported accessing the internet daily. This probably reflects the rising trends in internet use by students over the years and newer studies from other regions need to be done to support this.

Almost all students in our study use the internet for entertainment and for WhatsApp messenger, which differs largely from previous studies where there was a majority but more modest use of the internet for entertainment in Puducherry (76.6%),[13] Akola (66.67%),[11] and Iran (62%),[9] with only a quarter doing so in Mangalore.[10] WhatsApp, being a recent invention, does not feature in any of the studies. Social networking was also popular among students here similar to those in Akola (80%),[11] Turkey (93.4%),[15] and Kenya (99%).[16] A majority of our students were also in favor of using social media platforms for academics, which has already been done in Turkey[15] where 89.3% used it professionally.

The internet was used for academics by a large proportion of our students (86.8%), which has been the findings of India in Puducherry (75.9%)[13] and Akola (76.79%),[11] though lesser in Mangalore (15%)[12] and Meerut (21.6%).[10] Abroad, Iran had a high usage (95.50%)[9] with the modest levels of use in Lahore (61%)[6] and Cameroon (41%).[1] However, despite the high proportion of internet usage in academics, our students expressed doubts regarding the authenticity of academic material found online. Further, only a quarter of the students knew how to use the institutes' library resources to look up journals. This reveals a lacuna in the students' ability to effectively find academic material, despite having the resources for the same. This is also reflected in their desire to learn more efficient ways of accessing reliable academic material online. A majority of students in our study were also interested to have training in statistical methods in research, which is a favorable finding indicating a growing interest among undergraduates toward research. Our results were indicative that senior students would be more receptive to additional training and the introduction of newer methods of learning.

In addition, majority favored e-learning as a novel and interesting learning tool. Previous studies that have looked into the students' interest in incorporating e-learning into the medical curriculum had also shown mainly positive attitudes.[1],[5],[12] Students cited loss of interaction with teachers as the most common limitation indicating that e-learning should be a complementary to traditional teaching methods. Options for blended learning models seem viable for incorporation into medical teaching for undergraduates.

Many smart phone applications (app.) are already available on standard operating systems. Of note, the AIIMS-WHO Collaborating Centre Standard Treatment Protocols app. for the management of sick newborns was created by neonatologists to aid physicians and nurses in remote settings. Studies have demonstrated the efficacy of this novel tool among pediatricians.[17] Similar applications would be welcome, with further studies done to explore their effect on enhancing knowledge among MBBS students.


  Conclusion Top


India is currently experiencing exponential technological growth with the central government's new Digital India movement through which it aims to bring technological connectivity to every citizen in the country. As this vision transforms into a reality, medical students across the country would be able to access diverse academic content even from remote areas for study and work. This has wide public health implications wherein the diverse population of our country has the opportunity to be cared for by health providers who are connected across the internet and have access to the best resources and training.

Further interventional studies are needed to evaluate the e-learning options available within medical teaching methodology. Feasibility along with its comparison to traditional teaching methods will be key for making a case for its incorporation in the future.

Acknowledgment

We acknowledge the Indian Council of Medical Research for encouraging and funding the study under the ICMR-Short Term Studentship program of 2016 (Ref. ID: 2016-02850).

Financial support and sponsorship

We acknowledge the Indian Council of Medical Research for encouraging and funding the study under the ICMR-Short Term Studentship program of 2016 (Ref. ID: 2016-02850).

Conflicts of interest

There are no conflicts of interest.

 
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