KNOWLEDGE AND PERCEPTION OF TELEMEDICINE AMONG MEDICAL STUDENT OF THE UNIVERSITY OF UYO

CHAPTER ONE

INTRODUCTION

Background of the study

With a wide array of innovation in healthcare delivery has risen the adoption of information communication technology in healthcare environments. These terms encompassed in this category are telehealth, telemedicine, m-Health, and eHealth.  Of the most frequently used is the adoption of telehealth which refers to the delivery of healthcare services or related activities, such as education, when patients or clients are physically separated by a distance (Wilson, 2017). Telehealth, as defined by Agbaje (2022), encompasses the utilization of telecommunication technology for diverse healthcare applications, including diagnosis, consultation, treatment, transfer of medical data, education, and dissemination of public health alerts and emergency updates. Telehealth is the use of telecommunications technology to deliver clinical diagnoses, services, and patient consultations (Wilson, 2017).

Telemedicine provides various advantages, such as better healthcare accessibility, decreased travel time and expenses, and improved patient convenience. Additionally, it allows healthcare providers to access a wider range of patients and provides possibilities for immediate consultations and expert opinions (Akala et al., 2022). Amidst the COVID-19 epidemic, telemedicsine emerged as an essential instrument for upholding healthcare provision while complying with social distancing protocols. Telemedicine can overcome this obstacle and enable healthcare professionals to fulfil their duty of care without endangering the lives of their patients (Banwat et al., 2023). The achievement of universal health coverage for all is strongly connected to the incorporation of telemedicine into a health system's comprehensive strategy, as it has the capacity to mitigate the effects of geographical inaccessibility and staffing shortages (Nathaniel et al., 2022). 

Apparently, like other technologies, the majority of telemedicine deployment problems are attributed to human factors (Noel et al., 2022). The adoption of telemedicine services by health providers is crucial for the sustainable utilization of telemedicine. Clinicians must have a positive perception of telemedicine in order to freely continue using it (Carter et al., 2020). However, the implementation of telemedicine among healthcare professionals has been notably sluggish and discouraging, especially in underdeveloped nations (Anderson et al., 2020). Insufficient education and training, as well as negative attitudes, are significant obstacles that prevent professionals from utilizing telemedicine (Salako, 2021). The telemedicine training and experiential components in undergraduate medical curricula are insufficient, which may contribute to professionals' inadequate knowledge (Noel et al., 2022). Health professionals have considered telemedicine to be disruptive to the traditional healthcare delivery process. They believe it increases their workload, reduces their clinical autonomy, and exposes them to diagnostic uncertainty and errors that could lead to malpractice claims. Additionally, they feel that there is a lack of legal protection for providers in the telemedicine field (Wade et al., 2021).

1.2 Statement of the Problem

The utilization of this technology has multiple benefits, such as enhanced availability of healthcare services, improved cost-effectiveness, and higher convenience for both patients and healthcare professionals (Chibuzo et al., 2022). The preparation and acceptability of future healthcare professionals play a crucial role in the successful introduction and integration of telemedicine into healthcare systems, notwithstanding its increasing significance. 

Prior research on telemedicine knowledge and perception has primarily focused on practicing healthcare professionals, neglecting medical students who represent the future of the healthcare workforce in an increasingly digital world. It is crucial for medical students to be prepared for telemedicine in order to ensure the long-term sustainability of healthcare (Noel et al., 2022).  Health professionals have identified lack of education and training as significant obstacles to implementing telemedicine. To bridge this gap, medical schools will play a crucial role in equipping future medical professionals with the necessary knowledge and skills from the beginning of their careers (Nkala, 2023). 

Notably, telemedicine is still in its early phases of implementation in Nigeria, and there is a lack of research on the understanding, knowledge, and perception of this technology among medical students, who are the future healthcare professionals (Ebong, 2024). It is essential to assess the level of preparedness of medical students at the University of Uyo in Akwa Ibom State on their ability to effectively utilise telemedicine in their future professions. Their degree of expertise and their attitudes towards telemedicine will be crucial in deciding the successful integration of this technology into the healthcare system in the region. Therefore, the results of this study will offer valuable knowledge that can assist medical schools in evaluating the telemedicine aspect of medical education and training.

Objectives of the study

The primary objective of this study is to critically assess the knowledge and perception of telemedicine among medical students of the University of Uyo. Specific objectives of this study are to:

To evaluate the extent of understanding medical students have about telemedicine in University of Uyo.

To explore the perceptions, attitudes, and willingness of medical students to use telemedicine in their future practice.

To identify the factors that may hinder the adoption of telemedicine among medical students in University of Uyo.

To suggest strategies for improving telemedicine education and training in the medical curriculum at the University of Uyo

1.4 Research Questions

The following research questions which are in line with the objectives of this study will be answered in this study:

What is the extent of understanding medical students have about telemedicine in University of Uyo?

What are the perceptions, attitudes, and willingness of medical students to use telemedicine in their future practice?

What are the factors that may hinder the adoption of telemedicine among medical students in University of Uyo?

What are the strategies for improving telemedicine education and training in the medical curriculum at the University of Uyo?

1.5 Research Hypotheses

To determine the effectiveness of this study, the following research null hypotheses will be formulated to guide the study and it will be tested at 0.05% levels of significance.:

Ho: The extent of understanding medical students have about telemedicine in University of Uyo is low

Ha: The extent of understanding medical students have about telemedicine in University of Uyo is high.

1.6 Significance of the study

The knowledge and perception of telemedicine among medical students are critical determinants of its future success and integration into healthcare systems. By examining these aspects among the students of the University of Uyo, this study aims to shed light on their preparedness to engage with telemedicine and to identify areas where educational improvements are needed. The study will serve as a baseline to policymakers, medical students and institutions. It will also be of high significant to students and scholars.

Understanding the current level of knowledge about telemedicine among medical students can reveal gaps in the curriculum. This insight can guide educators in developing or enhancing courses related to telemedicine, ensuring future doctors are well-prepared for modern healthcare practices. Understanding the knowledge gaps and perceptions of medical students can inform curriculum development to better prepare them for telemedicine. 

Moreover, Improved readiness and acceptance of telemedicine among future healthcare providers can enhance the quality and accessibility of healthcare services in Nigeria. As future healthcare providers, medical students' perceptions of telemedicine can shape their willingness to adopt and integrate it into their practice. Positive perceptions may lead to increased adoption, potentially improving healthcare accessibility and efficiency in Akwa Ibom State and Nigeria as a whole. Improved knowledge and positive perception among medical students can potentially translate into better patient care and increased healthcare access, particularly in underserved areas where telemedicine can bridge gaps in service delivery.

Also, Insights from this study can aid policymakers in developing strategies and policies that support the integration of telemedicine into the healthcare system. Insights from the study can contribute to evidence-based policy recommendations aimed at integrating telemedicine into the healthcare system of Akwa Ibom State. This could involve advocating for infrastructure development, regulatory frameworks, and training programs tailored to local needs.

Furthermore, future scholars will utilise it as a thorough examination of the current body of literature. Consequently, other students with an interest in studying this subject will have the opportunity to utilise this work as preexisting information that can be exposed to critical evaluation. This study adds to the scholarly discussion on the knowledge and perception of telemedicine among medical students of the University of Uyo. 

1.7 Scope of the study

Broadly, this study focuses to critically assess the knowledge and perception of telemedicine among medical students in Nigeria. Specifically, this study seeks to evaluate the extent of understanding medical students have about telemedicine in Nigeria and explore the perceptions, attitudes, and willingness of medical students to use telemedicine in their future practice. 

Further, this study will focus on identifying the factors that may hinder the adoption of telemedicine among medical students in Nigeria and it also seeks to suggest strategies for improving telemedicine education and training in the medical curriculum in Nigeria Universities.

1.8 Limitations of the study

As is customary in any human endeavour, the researchers encountered modest constraints during the investigation. The primary constraint was the scarcity of comprehensive literature on the topic, the knowledge and perception of telemedicine among medical students of the University of Uyo. Therefore, a substantial allocation of time and exertion was required to identify suitable resources, publications, or information and collect data.

 Furthermore, this study is limited by its limited sample size and restricted geographic reach, namely concentrating exclusively on the University of Uyo, Akwa Ibom state. Hence, the generalizability of the findings in this study is limited, necessitating additional research. 

In addition, the researcher encountered a time limitation as a result of the necessity to do this research while simultaneously completing the responsibilities of attending lectures and engaging in other educational endeavors.

1.9 Definition of terms

Telehealth: Telehealth involves the delivery of healthcare services using digital technologies and telecommunications.

Telemedicine: Telemedicine encompasses a range of electronic communication methods, such as video calls, phone conversations, and online messaging, that enable the diagnosis, treatment, and management of patients without the requirement of face-to-face appointments 

Perception: Perception is the organization, identification, and interpretation of sensory information in order to represent and understand the presented information or environment.