Smartphone dependency and its impact on academics among medical and nursing stud

Rakesh SHARMA, Vibhuti VAIDYA,Rincy RAJAN, Anumol Thottiyil ELDHOSE,Hemkala RATRE, Hemant Lata RAI

1Department of Neurosciences Nursing, College of Nursing, All India Institute of Medical Sciences, Rishikesh, Uttarakhand,India; 2Department of Pediatrics, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India; 3Department of Emergency, All India Institute of Medical Sciences, Raipur,Chhattisgarh, India; 4Obstetrics and Gynecology Nursing,Government College of Nursing, Raipur, Chhattisgarh, India

ABSTRACT

Objective:This study aimed to assess smartphone dependency and its impact on academics among medical and nursing students.

Materials and Methods:A cross-sectional study was carried out on Bachelor of Medicine and Bachelor of Surgery (MBBS) and Bachelor of Science in Nursing (BScN) students in a medical teaching institute.The Smartphone Dependency Scale and self-structured questionnaire on impact of smartphone on academics were used to assess smartphone dependency and its impact on academics.A total of 436 students were selected using the total enumerative sampling technique.Data were analyzed using the descriptive (frequency, percentage, mean, and standard deviation) and inferential (t-test, Chi-square test) statistics.

Results:The mean age of students was 20.6 ± 1.29 years, 81% were females, and the mean body mass index score was 21.59 ± 3.41 kg/m2.The mean impact on academics and smartphone dependency scores was 19.92 ± 7.01 and 48.58 ± 11.46, respectively.The impact on academics had a significant association with student category (P ＜ 0.001) and gender (P ＜ 0.001).A significant association was found between the impact on academics (P = 0.003) and smartphone dependency (P = 0.05) with studying class.

Conclusion:The use of smartphones is more among medical students.Students studying in the first and second years are found to be more dependent on smartphone, which caused a serious impact on their academics.Smart appliances have become mandatory in this era of technology,and it is not possible to stop its usage but negative impact of smartphones on students’ academic performance needs to be addressed.Therefore,it is mandatory to organize educational seminars and workshops to promote the appropriate use of smartphones.

Keywords:Internet addiction disorder, medical, nursing, smartphone, students

INTRODUCTION

Globally, a revolution of technology is taking place to make human life more and more comfortable.Everyone needs quickly accessible information, faster communication, more and more fun in life.The craving for more technology results in the excessive usage of technology,[1]individuals spend lots of time in technology and gadgets,[2]which gradually control one’s day-to-day activities, finally being addicted with it.[3]

Smartphones are compact devices, usually pocket-size colored touch screen, and the most common use is to place and receive calls for voice communication and short text messages.These devices consist of multiple applications such as a digital camera to capture pictures and to make video, media players, calendar to save events and as reminders, the Global Positioning System navigation, video calling, video games, E-mails, social media apps, calculator,Google, and many more applications.[4]These applications have made smartphones an essential part of human life in the present era.Smartphone addiction has become a serious problem that affects one’s physical, psychological as well as social health.[5]In many developed and developing countries,more than half of the population are using smartphone,and this market is increasing globally.[6]In 2018, India was rated as the second rank in the world’s largest smartphone producer.[7]The overuse of smartphones is a form of compulsive behavior which is observed more among college students.In the studies from India, smartphone addiction has been included in the 10thedition of the International Classification of Disease-10 under the classification of Mental and Behavioral Disorders criteria for dependence syndrome.[8,9]

A smartphone is helpful for the students in searching for new information, sending and receiving files from teachers and classmates.[10,11]Whereas, recent literature reveals that the majority of college students use their smartphones for leisure activities such as playing video games, chatting on social media, and watching videos and movies.[12,13]The excessive use of smartphones is a sign of addiction to smartphone.[14,15]It has been evident that overuse of these devices can place a person at risk of developing psychopathological conditions,especially for college students.The overuse of smartphones can negatively impact the health, academic performance,and social life of students.Students become more and more dependent on smartphones.[15,16]Hence, to have more scientific data and evidence, this study was aimed to assess smartphone dependency and its impact on academics on academics among medical and nursing students.

MATERIALS AND METHODS

Ethical considerations

This study was conducted after obtaining permission from the Institutional Ethical Committee (ECR/714/Inst/CT/2015,dated March 22, 2017).Written consent was obtained from all the study participants.

Study design and setting

A cross-sectional study was conducted among Bachelor of Medicine Bachelor of Surgery (MBBS) and Bachelor of Science in Nursing (BScN) students at the tertiary care level medical teaching institute between January and February 2017.The study participants were selected by using the total enumerative sampling technique.

Participants selection criteria

Participant’s inclusion criteria were medical and nursing students who were available at the time of data collection and willing to participate in the study.Those diagnosed and on treatment for any kind of mental health problem or psychological issues were excluded from the study.

Data collection procedure

Administrative permission also was obtained from the Medical and Nursing College and then the primary researcher (RS) consulted with respective heads of the departments to interact with students for data collection.The timetable of all the batches of medical and nursing students was collected, and based on their free classes data collection plan was prepared so that teaching-learning activities of the students should not be disturbed.Those who agreed to participate were explained about the aim of the study and requested to give written informed consent.Participants took around 30-40 min to complete the given questionnaire on smartphone dependency and its impact on academics.

Data collection tools

The questionnaire had three sections:The first section was demographic information about age, gender, studying in the class, family income, body mass index (BMI), and number of smartphone used by them.Furthermore, students were explored regarding the purpose of keeping smartphone,where they keep and mode of smartphone most of the time, preferred ear during a voice call.To compute BMI,height and weight of students were measured.Weight measurement was done by using a Krups Weighing Scale,and height was assessed in a standing position without shoes by using an stadiometer.BMI scores were classified as underweight (＜18.5 kg/m2), normal weight (18.5-24.9 kg/m2), overweight (25-29 kg/m2), and class I and above obesity (≥30 kg/m2).

In the second section, a smartphone dependency questionnaire was used.It was a self-structured five-point Likert scale that included 20 questions statements, assessing students’ dependency on smartphones.Each statement was rated as “Always = 5, Most of the time = 4, Sometime = 3,Rarely = 2, and Never = 1.”

In the third section, a self-structured five-point Likert scale was used to assess the impact of smartphone on academics in which students were asked about “howsmartphoneuse isaffectingyouracademicperformance,sociallifeetc.?.” It consists of 10 questions statements, and each was rated as“Always = 5, Most of the time = 4, Sometime = 3, Rarely = 2 and Never = 1.”

Interpretation of scores

Based on the scores obtained, a range was created to divide the impact on academics and smartphone dependency.The range of scores scored by students on the impact on academics was from 13 to 27 and 37-60 for smartphone dependency.

The mean and standard deviation values were computed.The standard deviation value was added and subtracted from the mean score to obtain the following categories to interpret the impact on academics and smartphone dependency.Hence, score interpretation for the impact on academics was reported as:＜13 = mild impact; 13-27 = moderate;＞27 = severe.Similarly, for smartphone dependency, the scores were interpreted as:＜37 = mild level of smartphone dependency; 37-60 = moderate; ＞60 = severe.

Validity and reliability of tools

The data collection questionnaire was validated by five experts from the Departments of Community Medicine,Physiology, Psychiatry, Medicine and College of Nursing.All three sections were tailor-made self-reported questionnaires developed based on the previous literature.Reliability of tools was computed by the test-retest method, and obtained value of correlation coefficient (r) of impact on academics and smartphone dependency was 0.78 and 0.81,respectively.Reliability of the questionnaire was performed by test-retest method, and a high-reliability coefficient was found.

Statistical analysis

Data were entered into an Excel spreadsheet for the analysis.Descriptive statistics, including frequency, percentage, mean,and standard deviation, were used for central and deviation indexes.Inferential statistics were used to find the level of association between the selected personal variables and impact of smartphone dependency on academics and smartphone dependency measurement scale.

RESULTS

In the present study, we approached 448 medical and nursing students; among them, except 12 nursing students,436 returned forms (overall response rate was 97.32%).All the forms were screened and were found completely filled.The age was ranged from 17 to 25 years, and the mean age of participants was 20.6 ± 1.29 years.An almost equal number of students were from each class, except the 4thyear.Regarding BMI, the mean BMI value of participants was 21.59 ± 3.4 kg/m2.Few students (18%) were found underweight, and 16% of students had above normal body weight [Table 1].

Table 1:Demographic profile of students

Around 72% of students had reported a moderate level of smartphone dependence, and a large number (71.6%)of students had a moderate level of impact on academics because of smartphone usage.The impact on academics and smartphone dependency had shown a significant relationship (P＜ 0.01) [Table 2].

Table 2:Smartphone dependency, impact on academics, and its relationship among students (n=436)

It was found that there was a significant association between students’ category, gender, and studying class with academic impact.Furthermore, students’ class or year in which they were studying was found to have a significant association with their smartphone dependency [Table 3].

Table 3:Association between impact on academics and smartphone dependency with selected demographic variables (n=436)

The average time spent per day by students was 286.1 min.The highest average time (75.3 min) was spent on WhatsApp messenger followed by voice call (50.7 min) and the least on shopping (8.4 min) and in my opinion (IMO)/Instagram (13.6 min).It was also noted that students spent an average of 39.8 min on their academics-related activities or learning [Figure 1].

Figure 1:Average time duration spent on smartphone per day with different purposes

DISCUSSION

In the present era, a large number of populations, especially the young generation, is spending their time and enjoying smartphone.However, recent literature has been revealed that the excessive use of smartphones can influence daily routine life and may cause addiction.[17]This study is an attempt to explore smartphone dependency and its impact on academics among medical and nursing students.

On the impact on academics scale, a large number of students were moderately affected by the use of smartphone.Nearly half of students recorded from sometimes to always, they feel their marks are deteriorating, not getting enough time to study, and unable to concentrate on studies due to use of smartphone.These findings were supported by the various literature where smartphone severely impacted students,they got addicted to the smartphone, and the academic performance has deteriorated.[18-21]

The results of this study revealed that the average duration usage of the smartphone was 286.1 min (4.76 h)per day; that is a matter of concern as if this much time is spent on smartphone, then students may run out of time from the academic activities.Students were asked to give time duration spent with different purposes and found that the maximum smartphone usage was on WhatsApp messenger, followed by voice call, Facebook, academics,video game, and IMO/Instagram.Similarly, studies from West Bengal[22]and South Korea[23]have reported that the average usage of smartphone was ranged from 3.57 to 5.21 h/d for different purposes using the different applications.

Furthermore, the research shows that maximum time duration was spent on WhatsApp messenger.In smartphones,messaging is the most common feature, which is widely used by almost everyone.These results are in line with other studies from Turkey,[24]Germany,[25]claiming that most students are heavily using this chatting function.Browsing the social networking sites such as Facebook, Instagram/IMO were the applications on which students used to spend time.The next foremost application was gaming.In addition,students also reported that they were using smartphone for academic work, searching subject-related content.This indicates along with the negative aspects of smartphones,there are positive aspects that should be promoted among students.

Students expressed dependency on smartphone by agreeing that they were worried about losing their smartphone then wallet or purse, charging the battery of smartphone more than once a day, unable to stop using smartphone, felt disturbed and anxious when they forgot to carry a smartphone with them, and every time taking selfies and capturing photos every time.These are similar findings from various government and private universities and high educational institutions of India.[18]These statements show the students are getting addition for smartphones, which Parasuramanet al.[26]discussed in their studies.

It was also found that the impact of smartphone use was associated student’s category.A greater number of MBBS students were affected than B.Sc.nursing students.A study has shown similar findings where more medical students were addicted to smartphone use than nursing students.[27]In addition, gender moderates the impact of smartphone usage.In this study, maximum females were influenced than males and severely impacted by smartphone usage, which was also reported by Kadiret al.[28]In contrast, a study[27]has reported that more females were addicted than male students.

The present study found that a higher number of students from 2nd-year students were in moderate to severe class of impact on academics and smartphone dependency category.This is because, after admission, 1st-year students are in the new environment, away from home, and parents give them smartphone for the communication purposes.While in the 2ndyear, they might have more freedom and peer group influence to use smartphone.However, gradually, they are more mature, and with clinical responsibility, smartphone usage might decline.A similar phenomenon was reported by a study[29]from Pakistan where university students studying in the third and fourth semesters were using more smartphones than other semesters.

CONCLUSION

Dependency on gadgets among adolescents has been increasing nowadays, as they spend crucial hours of their day-to-day life on such appliances, which in the long run causes problems in academics and health and social life.The present study concluded that increased frequency of smartphone usage among college students leaves a serious impact on their academics.Students from the first and second year were more influenced and addicted to smartphone and expressed that their studies were affected.Therefore,institutions need to develop guidelines and protocols regarding smartphone usage and should also conduct educational activities on the healthy use of smartphones.

Acknowledgment

We would like to thanks to Amrita Bharti, Manju, Manisha,Razia Philip, Gyaneshwari Chandrakar, Gunjan Dubey.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.