Electronic Thesis and Dissertation Repository


Doctor of Philosophy


Health Information Science


Ajiferuke, Isola S.Y.


There is a challenge with healthcare access in most developing countries. With the high rate of mobile technology penetration in these countries, there is a strong belief that mobile technology can help address this and other health system and education challenges. This study investigated how clinical year medical students in Ghana used m-health and with what outcomes. This was a mixed-methods study to assess what technologies students used, what the impact of use was, what enablers and barriers they encountered, what factors explained m-health adoption and what the attitudes of students, staff and faculty members were towards m-health use. The study was conducted in four out of five medical schools in Ghana with clinical year students, namely, Kwame Nkrumah University of Science and Technology School of Medical Sciences (KNUST-SMS), University of Cape Coast School of Medical Sciences (UCC-SMS), University of Development Studies School of Medicine and Health Sciences (UDS-SMHS) and University of Ghana School of Medicine and Dentistry (UG-SMD). Online and paper questionnaires were distributed to 828 students and 291 questionnaires were returned. Questionnaires from dental students at UG-SMD (n = 5) were excluded from the analysis.Two focus group discussions were held involving seven students while three students, seven faculty members and five staff were interviewed. Qualitative data were analyzed using thematic analysis. Only one student did not own a mobile device. About 78% of students reported using m-health at some point during their medical education. The most popular devices used by students were laptop computers (90.8%), smartphones (66.2%), cellular phones (46.6%) and tablets (44.1%). Over 84% of the students owned Android devices, while 21% owned iPhones and iPads. Majority of students owned three devices or less. Students used mobile technologies in ways that suited their learning needs and contexts. M-health helped students to participate better in lessons and improve their knowledge, skills and efficiency in various contexts. The main drawbacks of m-health use were distraction and time wasting, difficulty in determining credibility of some online information and the risk of using these technologies inappropriately around patients and during assessments. The main facilitating conditions for m-health use were availability, quality and reliability of technological services, technical support, security, price value, technology competence and training, portability, task and goal fit, social influence and organizational factors. Habit and Hedonic Motivation were the only significant factors that explained intention to use m-health and actual m-health use respectively in the UTAUT2 model, in the presence of age, gender and experience. Students, staff and faculty members were open to using m-health in teaching and learning, although they recommended regulation of use through policies and guidelines to ensure effective teaching and learning and ethical m-health use. Considering the benefits offered by m-health, the study encourages medical schools in Ghana to explore mobile learning with the possibility of incorporating it into their curricula. This should be accompanied by development of policies and guidelines to spell out how mobile technologies should be used in order to mitigate most of the drawbacks identified. This study contributed empirical evidence from the Ghanaian context regarding m-health adoption and use in medical education. This evidence will contribute to theory regarding benefits, drawbacks, facilitating conditions and factors that influence m-health adoption among medical students in a developing country context. Understanding how medical students use mobile technology in learning will be useful in planning how m-health can be incorporated into their curricula. It will also help in informing development and deployment of m-health in healthcare in contexts similar to Ghana.

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.