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Indian Journal of Community Medicine

Internet use Among Medical Students and Residents of A Medical College of North India

Author(s): P. Lal, R. Malhotra, C. Ahuja, G. K. Ingle

Vol. 31, No. 4 (2006-10 - 2006-12)

P. Lal, R. Malhotra, C. Ahuja, G. K. Ingle

Introduction

The internet, one of the important scientific developments in this field, provides a wealth of information in relation to diseases, therapeutic procedures and pharmaceutical products1. It has a lower cost as compared to paper based dissemination of information and also has an added advantage of being available world wide instantly on demand. Therefore, there is a need not only to equip medical fraternity with adequate skills for use of internet but also to make internet facility available in institutions providing medical education and health care.

For providing internet access to medical students and resident doctors of Maulana Azad Medical College (MAMC), a government medical college admitting 200 undergraduate and 243 post graduate students every year, a private “Internet Cafe” was opened in its campus. Although, it is a government institution, the private internet facility was opened probably due to financial constraints on the part of college authorities. The internet cafe, opened in January 2004 has a total of 12 computers and utilizes cable internet connection with a maximum speed of 128kbps. It remains open from 10.00 AM to 7.00 AM daily, closing for only three hours in a day. It is open for all undergraduate and postgraduate medical students, senior resident doctors and faculty and charges a sum of Rs. 10/- for one hour of internet use. It is a centrally located facility in the campus. Besides this facility, postgraduates, senior resident doctors and faculty can also access internet in the college library, which is available free of cost but has only 2 computers and limited working hours as per government rules. At present there is no provision of internet access at the departmental or faculty level in the college.

The utilization of such internet facilities in a medical college would depend upon the percentage of students/residents who know how to operate a computer as well as the quality of services provided in the facility. Therefore, the current study was carried out to find out: (1) Use of computers and internet and purpose of using internet among students and resident doctors of Maulana Azad Medical College; (2) Level of dissatisfaction among them and reasons for the same in relation to services provided by the internet cafe in the college.

Material and Methods

The present cross sectional study was carried out in Maulana Azad Medical College and associated hospitals in September 2004. Out of the 5 batches of undergraduate MBBS students (UGs) in various semesters, only those who were in 1st, 3rd and 5th semester were available for inclusion in the study. Those who were in 7th and 9th semester were not included due to their pre-occupation with their university examinations. Data was collected from the UGs during their weekly lecture of community medicine using a self administered questionnaire. Information was collected regarding age, sex, use of computer and internet services, purpose of using internet and the reasons for dissatisfaction with regard to the internet cafe. All the questions were open ended. The same questionnaire was used to gather information from post graduate students and senior residents (PGs/SRs) working in various specialties. They were contacted during working hours in their respective departments. No specific sampling technique was employed for selecting the study subjects. Data was analyzed using EpiInfo. Chi-square test was used to find out statistical significance of differences in proportions. A p-value of <0.05 was considered to be significant.

Results and Discussion

A total of 449 study subjects comprising 332 UG students and 117 PGs/SRs were covered in the study. The age of the study subjects ranged from 17 to 38 years with a mean of 21.1 + 4.2 years. Majority of the UGs were male (58.1%) whereas majority of PGs/SRs were female (53.0%). Overall, 55.2% were males.

Use of computers, either for personal or professional purpose was reported by 382 (85.1%) study subjects, being significantly higher among PGs/SRs (94.9%) as compared to UGs (81.6%) (p<0.001). This was almost similar to the figures reported from a medical college in South India2. But, it was observed to be lower as compared to that reported among medical students at the University of Edinburgh (98%)3.The difference might be due to time of exposure to computer technology at the two places. At present, the use of computers in medical education and patient care at MAMC is limited. It is being used only in a few specialties viz. radiology, biochemistry. These specialties use automated systems for investigation purpose. At the same time, the use of computers by 85.1% participants in the present study in spite of limited availability of computers in the college/hospital was encouraging.

Majority of the study subjects (90.6%) were aware of the presence of the internet cafe in the campus. PGs/SRs (96.6%) were more aware than the UG students (88.6%) (p < 0.01). However, only 46.4% of the study subjects who were aware of its presence had ever availed of its services. Again, the use of the internet cafe was observed to be significantly higher among the PGs/SRs (66.4%) as compared to the UG (38.7%) students (p<0.001). The use of internet either at home or at facilities other than the internet cafe in campus was reported by 56.6% of the UG students and 78.6% of the PGs/SRs, the overall figure being 62.4%. This difference again was statistically significant (p<0.001).

Among the purposes of accessing the internet at the internet cafe in campus and at home/other facilities listed by the study subjects, the top 5 purposes were the same (Table I). They included educational (visiting websites providing information related to the medical field), receiving or sending an e-mail, surfing (visiting websites other than those related to the medical field), chatting and entertainment (e.g. games, songs, movies etc). These were similar to those reported by students from other medical colleges in India2,4,5. The use of the internet for educational purpose was observed to be higher among the PGs/SRs while use for surfing, chatting and entertainment was observed to be higher among the UG students. A similar finding has been reported by Inamdar from South India2. This might be possibly due to want of literature by PGs/SRs for preparing seminars and research work including thesis.

Table I: Purpose of Accessing the Interenet at the Campus Internet Cafe and Reasons for Dissalisfaction

Variable UG PG/SR Total
Purpose* (N = 114) (N = 75) (N = 189)
Education 45 (39.5) 62 (82.7) 107 (56.6)
E mail 63 (55.3) 29 (38.7) 92 (48.7)
Surfing 48 (42.1) 21 (28.0) 69 (36.5)
Chatting 29 (25.4) 2 (2.7) 31 (16.4)
Entertainment 15 (13.2) 0 (0.0) 15 (7.9)
Pornography 2 (1.8) 0 (0.0) 2 (1.1)
Others** 0 (0.0) 1 (1.3) 1 (0.5)
Reasons for
dissatisfaction:*
(N=59) (N=37) (N=96)
Slow speed of data transfer 49 (83.1) 28 (75.7) 77 (80.2)
Server not in order frequently 9 (15.3) 14 (37.8) 23 (24.0)
Long waiting period 8 (13.6) 5 (13.5) 13 (13.5)
Inadequate software content 7 (11.9) 5 (13.5) 12 (12.5)
Frequent closure of facility 9 (15.3) 2 (5.4) 11 (11.5)
Inadequate hardware 5 (8.5) 2 (5.4) 7 (7.3)
High cost 4 (6.8) 3 (8.1) 7 (7.3)
Computers hang frequently 4 (6.8) 2 (5.4) 6 (6.3)
Staff is impolite 1 (1.7) 5 (13.5) 6 (6.3)
Others # 7 (11.9) 6 (16.2) 13 (13.5)
No reason 0 (0.0) 1 (2.7) 1 (1.0)
* Not mutually exclusive Figures in parenthesis are percentages
** Submission of research papers, News, Shopping, Banking, Railway reservation
# Viruses in computer, A.C. ineffective, Lack of privacy
UG = under graduate, PG = post graduate, SR = senior resident

Among the 189 study subjects who had ever utilized the services of the internet cafe, 96 (50.8%) were dissatisfied with its services.

The proportion of dissatisfied UGs and PGs/SRs was nearly similar at 51.8% and 49.3% respectively. The primary reason for dissatisfaction, both among the UGs and PGs/SRs, was observed to be the slow speed of data transfer at the cafe (80.2%). Other important reasons were the server at the cafe was frequently out of order (24.0%), long waiting period due to inadequate number of computers (13.5%), inadequate software content of the computers (12.5%) and frequent closure of the facility (11.5%) (Table I). The dissatisfaction with the services is also refl ected in greater use of internet at home/other facilities (62.4%) as compared to use at the internet cafe present in the campus (46.4%), in spite of its long working hours and low cost of surfing the internet. By addressing the reasons responsible for dissatisfaction with the cafe and by providing training regarding computer use in the college for the medical students the use of internet could be increased and encouraged further.

References

  1. Towle A. Changes in health care and continuing medical education for the 21st centaury. BMJ 1998; 316:301-4.
  2. Inamdar SC, Rotti SB. Computer use among medical students in an institution in southern India. Natl Med J India 2004; 17: 8-10.
  3. Akoijam BS, Tinurenla A, Mingthanzuala, Th. Achouba Singh. Internet use among the post graduate trainees at RIMS. J Med Sci 2004; 18: 88-90.
  4. Mony PK, George KC, Chacko N. Computer use among post graduates of a medical college in southern India. Natl Med J India 2004; 17: 175-6.
  5. Asgari-Jirhandeh N, Haywood J. Computer awareness among medical students: A survey. Med Edu 1997; 31: 225-9.

Department of Community Medicine, Maulana Azad Medical College, New Delhi-110002.
E mail: [email protected]
Received: 17.3.05

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