Telemedicine literacy: an explanatory sequential mixed-method inquiry into awareness and experiences of medical students and clinicians in Islamabad.

BACKGROUND: Telemedicine services encompass a diverse range of fields, including telenursing, telepharmacy, telerehabilitation, teleradiology, telepsychiatry, and others. Despite these advancements, low-income countries still lag in telemedicine adoption. The study aimed to assess the knowledge of telemedicine among students and clinicians while gaining deeper insights into clinicians' experiences-how telemedicine has influenced their practice, the challenges they face, and the opportunities it holds for a resource-limited country like Pakistan.

METHODS: This study followed an explanatory sequential design. Participants were medical professionals, including MBBS students and clinicians (House Officers, Postgraduate Trainees, and Consultants) across three medical institutions: Islamabad Medical and Dental College (IMDC), NUST School of Health Sciences (NSHS), and Rawal Institute of Health Sciences (RIHS). Quantitative data from 5-point Likert scale questionnaires were analysed using IBM SPSS (version 21) with mean and standard deviation for interpretation. Qualitative insights from semi-structured interviews with telemedicine clinicians, guided by an interview guide, were analysed through coding, categorisation, memo analysis, and consensus building of audio recordings.

RESULTS: A total of 817 students, 23 house officers, and 26 clinicians participated in the study. Students exhibited lower familiarity (mean 2.00 ± 1.03) and knowledge (mean 1.87 ± 0.99) of telemedicine compared to house officers (mean 3.08 ± 0.848 and 2.86 ± 0.86, respectively) and clinicians (mean 2.81 ± 0.93 and 2.69 ± 1.01, respectively). The Kruskal-Wallis H test revealed a significant difference in overall scores across the three groups (p < 0.001), with students scoring distinctly lower (mean rank = 423.47) than house officers (mean rank = 615.70) and clinicians (mean rank = 587.47). The analysis of interviews led to the discovery of six themes: Clinical limitations, ethical and legal concerns, resource barriers, patient-related factors, future of telemedicine, and advantages of Telemedicine.

CONCLUSION: The study highlights a significant knowledge gap in telemedicine, particularly among students, underscoring the need for enhanced education and training in medical curricula. While clinicians demonstrate a better understanding and more positive perceptions, telemedicine's growing importance in modern healthcare highlights the urgency for infrastructure development and policy support to facilitate its integration.