Attitude, awareness, and knowledge of telemedicine among medical students: A systematic review of cross-sectional studies

Nursing students' awareness, knowledge, and attitudes regarding telehealth and telenursing use for high-quality healthcare: A cross-sectional study

BACKGROUND

Increasing technology use in healthcare has led to a focus on improving aspects of telehealth delivery to facilitate healthcare. Thus, students' understanding of the importance of telehealth and telenursing must be improved, as this plays a crucial role in shaping the future of healthcare. This study aimed to examine nursing students' awareness, knowledge, and attitudes regarding telehealth and telenursing use for high-quality healthcare.

METHODS

A cross-sectional study was conducted on a convenience sample of 204 nursing students attending a public university in Saudi Arabia. An online questionnaire, supplemented by additional instruments, was used for data collection. The required bivariate and multivariate analyses were used to analyze the collected data.

RESULTS

The study revealed that nursing students exhibited moderately high levels of awareness, knowledge, and attitudes regarding technology use for high-quality healthcare. Significant differences in the mean frequencies of internet use and knowledge (p < .05) and technology proficiency and knowledge (p < .05) were reported. The Pearson coefficient correlation test demonstrated that awareness was associated with knowledge (r = 0.350, p < .001), attitude (r = 0.660, p < .001), and years of technology use (r = -0.157, p = .025). Furthermore, attitude was significantly associated with knowledge (r = 0.295, p < .001) and years of technology use (r = -0.150, p = .032). In the regression, the awareness, knowledge, and attitude models were all significant (p < .05).

CONCLUSIONS

The study's findings emphasize the need for targeted interventions to enhance nursing students' technological proficiency and awareness of telenursing. The predictive relationships among awareness, knowledge, and attitude also emphasize the need for a comprehensive and integrated educational approach. Future qualitative research studies should explore nursing students' perceptions of telenursing and how this could lead to high-quality healthcare.

Digital health literacy among undergraduate nursing students in China: associations with health lifestyles and psychological resilience

BACKGROUND

Digital health literacy (DHL) is pivotal for individuals to access trustworthy health information and make informed decisions, closely intertwined with health behaviors and psychological resilience-these factors collectively shape an individual's approach to health management. Despite extensive research on digital health literacy in broader populations, the specific dynamics of digital health literacy in relation to health behaviors and psychological resilience among undergraduate nursing students in China remain understudied, highlighting a gap that this research endeavors to address. This study aims to assess the levels of digital health literacy among undergraduate nursing students in China, and to explore its association with health lifestyles and psychological resilience, which are considered influential factors.

METHODS

Employing a descriptive cross-sectional research design, eligible Chinese nursing undergraduates were surveyed from June to October 2023. This study recruited a total of 418 undergraduate nursing students. After excluding 11 students on leave, 407 students participated in questionnaire completion and submission. The College Students' Digital Health Literacy Scale, Healthy Lifestyle Assessment Scale and The Psychological Resilience Scale were used in this study.

RESULTS

The mean scores for digital health literacy, health lifestyles, and psychological resilience were 74.78 ± 8.44, 127.14 ± 11.22, and 79.21 ± 11.02, respectively. Pearson correlation analysis results indicated that the correlations between digital health literacy and both health lifestyles (r = 0.707, P < 0.01) and psychological resilience (r = 0.638, P < 0.01) were statistically significant and positive. The multiple linear regression analysis revealed that volunteer activity experience, academic performance, physical fitness, psychological traits, health lifestyle, and psychological resilience significantly predicted digital health literacy (F = 58.091, P < 0.001, R² = 0.678, adjusted R² = 0.666). Specifically, excellent academic performance (β = 0.210, P < 0.001) and good physical fitness (β = 0.188, P = 0.002) were the strongest predictors of higher digital health literacy.

CONCLUSIONS

There is a correlation between the digital health literacy of nursing undergraduates and their health lifestyles and psychological resilience. Future research should consider interventions in digital health literacy for undergraduate nursing students in China from the perspectives of health lifestyles and psychological resilience.

The digital readiness of future physicians: nurturing the post-pandemic medical education

BACKGROUND

The COVID-19 pandemic has accelerated the integration of digital technologies in the healthcare sector. Telemedicine has notably emerged as a significant tool, offering a range of benefits. However, various barriers, such as healthcare professionals' insufficient technological skills and competencies, can hinder its effective implementation. Scholars have examined the readiness of future physicians, with some studies exploring their readiness before or during the COVID-19 crisis. There is, however, a noteable gap in the literature concerning the post-pandemic period. This study aims to identify gaps in current medical education programs by examining two primary aspects: (1) technical readiness (encompassing general and health-related digital competencies) and (2) behavioural readiness, which includes prior experiences and future intentions related to telemedicine education and implementation among medical students and residents.

METHODS

A cross-sectional study was conducted using a web-based questionnaire administered to medical students and residents at a major Northern Italian university. The survey responses were analyzed to ascertain whether their distributions varied across demographic variables such as gender and level of education.

RESULTS

The most commonly owned technologies were laptops and smartphones, with smartphones perceived as the easiest to use, while desktop computers presented more challenges. Approximately 38% of respondents expressed apprehension about applying digital health information in decision-making processes. There was a significant lack of both personal and academic experience, with only 16% of students and residents having used telemedicine in a university setting. Despite this, 83% of participants expressed a desire for training in telemedicine, and 81% were open to experimenting with it during their academic journey. Moreover, 76% of respondents expressed interest in incorporating telemedicine into their future clinical practice.

CONCLUSIONS

This study highlights the need for medical students and residents to receive specific education in digital health and telemedicine. Introducing curricula and courses in this domain is critical to addressing the challenges of digital healthcare.

Evaluation of no-show rate in outpatient clinics with open access scheduling system: A systematic review

Background

Patients' missed appointments can cause interference in the functions of the clinics and the visit of other patients. One of the most effective strategies to solve the problem of no-show rate is the use of an open access scheduling system (OA). This systematic review was conducted with the aim of investigating the impact of OA on the rate of no-show of patients in outpatient clinics.

Methods

Relevant articles in English were investigated based on the keywords in title and abstract using PubMed, Scopus, and Web of Science databases and Google Scholar search engine (July 23, 2023). The articles using OA and reporting the no-show rate were included. Exclusion criteria were as follows: (1) review articles, opinion, and letters, (2) inpatient scheduling system articles, and (3) modeling or simulating OA articles. Data were extracted from the selected articles about such issues as study design, outcome measures, interventions, results, and quality score.

Findings

From a total of 23,403 studies, 16 articles were selected. The specialized fields included family medicine (62.5%, 10), pediatrics (25%, four), ophthalmology, podiatric, geriatrics, internal medicine, and primary care (6.25%, one). Of 16 articles, 10 papers (62.5%) showed a significant decrease in the no-show rate. In four articles (25%), the no-show rate was not significantly reduced. In two papers (12.5%), there were no significant changes.

Conclusions

According to this study results, it seems that in most outpatient clinics, the use of OA by considering some conditions such as conducting needs assessment and system design based on the patients' and providers' actual needs, and cooperating of all system stakeholders through consistent training caused a significant decrease in the no-show rate.

Assessing Telemedicine Competency Among Doctors in a Tertiary Care Hospital: A Questionnaire-Based Cross-Sectional Study

Background The use of telemedicine in contemporary healthcare has become essential, providing a novel method of delivering care, particularly in rural and underdeveloped areas. This study assesses the telemedicine awareness, knowledge, attitude, skills, and challenges among physicians working in tertiary care hospitals. Methods A cross-sectional study was carried out with 100 doctors from diverse specialties at a tertiary care institution. The questionnaire evaluated five domains: telemedicine awareness and knowledge, telemedicine attitude, telemedicine technology skills, telemedicine utilization patterns, and perceived barriers and educational needs. Results The study indicated that 95% of participants were aware of telemedicine. However, knowledge gaps remained, particularly in legal and ethical concerns (50%) and international rules (40%). Eighty percent of respondents had a favorable opinion of telemedicine, and 85% thought it might improve patient care in rural regions. The proficiency level of telemedicine users was variable: 60% of them had previous experience, and 70% of them rated their proficiency as intermediate or better. According to utilization patterns, 50% of telemedicine users used it at least once a week, primarily for remote monitoring (30%) and video consultations (60%). The study found that 90% of respondents had a high demand for training and educational opportunities. The absence of infrastructure (65%), worries about data security (55%), and patient acceptability (30%) were the main obstacles found. It also highlighted how important it is to have defined policies and collaborate across disciplines. Conclusion The study identifies a good attitude toward telemedicine among doctors as well as a need for improved training and infrastructure. It is essential to tackle these requirements and obstacles in order to successfully incorporate telemedicine into healthcare systems.

Awareness, Knowledge, Attitude, and Skills (AKAS) of Telemedicine and Its Use by Primary Healthcare Providers

Background

This study aimed to determine the rate of telemedicine (TM) use and the levels of awareness, knowledge, attitude, and skills of TM among primary healthcare (PHC) providers.

Methods

In a cross-sectional study, 104 PHC providers were subjected to a validated AKAS scale via Survey Monkey. The tool consists of 4 parameters that users can respond to using a 4-point Likert scale to assess their awareness (12 statements), knowledge (11 statements), attitude (11 statements), and skills (13 statements) on TM. Total and percentage mean scores (PMS) were calculated for each parameter. Participants were categorized in each parameter into three categories: low (≤ 49% score), average (50-70% score), and high (≥ 71% score) levels. The association of AKAS levels with personal characteristics and TM use was investigated. The significance was set at p<0.05.

Results

One-half of participants (51%) reported current use of TM, and two-thirds (63.5%) reported a high level of AKAS, with a PMS of 72.9±14.7, 95% CI: 70.1-75.7. There were significant associations between the following: years of experience and levels of knowledge (Χ2LT = 6.77, p= 0.009) and skills (Χ2LT = 4.85, p = 0.028), respectively; and total household income and levels of skills (Χ2LT = 6.91, p= 0.009). The rate of TM use was significantly associated with awareness levels (Χ2LT = 6.14, p = 0.013). Lack of training ranked as the first barrier (45.5%), followed by connection problems and tools' unavailability (35.1% each). The participants recommended providing TM training (41.1%) and stabilization of connection and networking signals (30.1%).

Conclusion

Despite their high level of TM awareness, the rate of TM use by PHC providers is less than satisfactory. Establishing standardized TM training and supporting the network signals are recommended. A large-scale study on the impact of TM integration with PHC services is necessary.

The effect of machine learning algorithms in the prediction, and diagnosis of meningitis: A systematic review

Background and Aims

This systematic review aimed to evaluating the effectiveness of machine learning (ML) algorithms for the prediction and diagnosis of meningitis.

Methods

On November 12, 2022, a systematic review was carried out using a keyword search in the reliable scientific databases PubMed, EMBASE, Scopus, and Web of Science. The recommendations of Preferred Reporting for Systematic Reviews and Meta-Analyses (PRISMA) were adhered to. Studies conducted in English that employed ML to predict and identify meningitis were deemed to match the inclusion criteria. The eligibility requirements were used to independently review the titles and abstracts. The whole text was then obtained and independently reviewed in accordance with the eligibility requirements.

Results

After all the research matched the inclusion criteria, a total of 16 studies were added to the systematic review. Studies on the application of ML algorithms in the three categories of disease diagnosis ability (8.16) and disease prediction ability (8.16) (including cases related to identifying patients (50%), risk of death in patients (25%), the consequences of the disease in childhood (12.5%), and its etiology [12.5%]) were placed. Among the ML algorithms used in this study, logistic regression (LR) (4.16, 25%) and multiple logistic regression (MLR) (4.16, 25%) were the most used. All the included studies indicated improvements in the processes of diagnosis, prediction, and disease outbreak with the help of ML algorithms.

Conclusion

The results of the study showed that in all included studies, ML algorithms were an effective approach to facilitate diagnosis, predict consequences for risk classification, and improve resource utilization by predicting the volume of patients or services as well as discovering risk factors. The role of ML algorithms in improving disease diagnosis was more significant than disease prediction and prevalence. Meanwhile, the use of combined methods can optimize differential diagnoses and facilitate the decision-making process for healthcare providers.

The effect of telerehabilitation on improving the physical activity of patients with osteoarthritis: A systematic review

This systematic review aimed to evaluate the effect of telerehabilitation on improving physical activity, physical function, and quality of life in patients with osteoarthritis (OA). A systematic review of randomized controlled trial studies was conducted without a time limit by searching for keywords in the title, abstract, and study keywords in the scientific databases Embase, Web of Science, Scopus, and PubMed on October 20, 2021. This study was conducted according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Titles and abstracts were retrieved based on the inclusion, exclusion, and quality assessment criteria. Then, full texts were retrieved and reviewed independently by two separate authors based on the eligibility criteria. Disputes were resolved through discussion. A form with the same predefined elements was used to extract data. Totally, eight eligible articles were found through this review. The studies on telerehabilitation approaches were categorized into three categories, which are: home-based exercise programs by online mobile applications, sports counseling and physiotherapist support via telephone calls, and Internet-based exercise training (IBET). In four studies (57%), telerehabilitation was effective in the short term for some months and improved the performance, self-efficacy, and quality of life of participants. On the other hand, in the long-term effects, there was no difference in participants' improvement (43%). In long-term follow-up, there was no difference between the efficiency of traditional rehabilitation and telerehabilitation in improving the physical performance and quality of life. However, telerehabilitation can be a viable alternative to traditional physiotherapy in patients with OA.

Telemedicine perception and interest among medical students at the University of Sharjah, United Arab Emirates, 2023

BACKGROUND

Telemedicine is becoming an integral part of healthcare. Training medical students in telemedicine is encouraged by many medical organizations. However, in the United Arab Emirates in particular, most medical schools have not incorporated it into their curriculum. Therefore, this study aims to assess medical students' perceptions and interest in telemedicine teaching at the University of Sharjah, UAE.

METHODS

A questionnaire-based survey was built based on the current literature and was distributed to all medical students at the University of Sharjah between February and March 2023. The questionnaire assessed the participants for their demographic data, access to and use of digital devices, exposure to and beliefs related to telemedicine, and their medical school experience with distance learning and telemedicine. The data were analyzed via simple statistics, and the Chi-square test was used to assess the associated factors affecting the participants' interest in receiving telemedicine teaching.

RESULTS

The questionnaire had a 70.4% (547/777) response rate. The mean age (SD) of the participants was 20.7 years (1.57), and the majority were female (68.4%). Over 98% of the students reported having easy access to and being comfortable with using computers and the internet. Most students (90.5%) believed that the medical school curriculum should include teaching in telemedicine; however, 78.2% of these students stated that it should be included as an elective course. The participants' interest in receiving teaching in telemedicine had a statistically significant association with the following factors: being female, being familiar with telemedicine, having read literature on telemedicine, having beliefs that telemedicine is an opportunity to improve current medical practice, that its use should be encouraged, that it has an important role to play in healthcare, that it does not pose greater threat to current medical practice, having a preference to continue distance learning at medical school and having an interest in incorporating telemedicine in their future careers.

CONCLUSIONS

It is an ideal time to incorporate telemedicine into the medical curriculum at the University of Sharjah with most students expressing interest in it. However, further research is needed to assess its applicability to other medical schools in the country and elsewhere.

Knowledge and Perception of Telemedicine among Medical Students of the University of Jos, Plateau State, Nigeria

Background

Telemedicine has promising potential to address the challenges faced by healthcare systems in developing countries, in providing equitable access to quality care. However, the practice of telemedicine is generally poor in these countries. The success of telemedicine like any technology depends on numerous factors including users' knowledge and perceptions. Hence, this study aimed to examine the knowledge and perceptions of telemedicine among medical students at the University of Jos.

Methodology

This was a cross-sectional study among 305 clinical medical students selected through a stratified sampling technique. A self-administered questionnaire consisting of a 28-item 5-point Likert response scale was used to collect data, comprising 13 items for knowledge, 8 for the perception of benefits, and 7 for the perception of ease of use of telemedicine. Data was analyzed using IBM-SPSS.

Results

One hundred and eleven (36.4%) participants had good knowledge of telemedicine, while 113 (37.1%) had a good perception of the benefits and 103 (33.8%) had a good perception of the ease of use. Respondents with a good knowledge of telemedicine were about five times more likely (OR = 5.24, 95% CI = 3.15 - 8.69) to have a good perception of the benefits and about eight times more likely (OR = 8.33, 95% CI = 4.57 - 14.26) to have a good perception of ease of use.

Conclusions

Few medical students possess desirable levels of knowledge and perceptions of telemedicine which portrays a gap in the medical education curriculum. Therefore, training, and educational opportunities are recommended to improve their knowledge and perception of telemedicine.