We identified major uses of smartphone as well as behavioural patterns in usage as quoted by medical students in out study.
Smartphone usage extent:
Our study results led to the development of a Venn diagram indicating the trends of mobile phone use among Pakistan's medical students as shown in Figure 1. The Venn diagram shows four overlapping circles representing different smartphone use trends among Pakistan medical students.
Information storage is the most popular primary function overall, with more females using it than males. Communication is another well-used function like information storage, again with slightly higher usage among females. Education stands out as a function primarily used by females [7]. Only a minimal number of males use it as their only smartphone function. While not the primary function for many, entertainment overlaps significantly with other categories, especially communication and education. This suggests that most people who use their phones for education or communication also incorporate entertainment. The central area where all four circles overlap likely represents people who utilize these functions. The largest overlap area suggests this is the most common usage pattern.
Dominant Usage Categories:
Information Storage: With the highest value of 46, information storage is the most prevalent use among medical students. Medical students use their smartphones for various purposes, including accessing medical applications that provide valuable clinical utility and sorting and storing various documents for future reference and use [8]. Additionally, the ease of capturing and sharing images with a smartphone makes it useful in clinical photography [9]. This trend is expected to grow as smartphones provide portable computation of data obtained from inbuilt sensors, making them valuable tools for medical professionals. This aligns with their studies, where accessing and storing medical resources, notes, and research materials is crucial.
Communication: Close behind with 38, communication remains important for academic collaboration, discussing cases, and staying connected with peers and faculty. Smartphones have also been reported to increase student involvement, improve the feedback process, and enhance communication between students and teachers in medical education[10]. For instance, instant messaging smartphone applications such as WhatsApp can be used as a method to facilitate communication and education among groups of medical students.
In addition to the high usage of smartphones for information storage and communication, smartphone applications are extensively used specifically for medical purposes. Medical students and junior doctors have shown a strong inclination towards using these apps, as they offer valuable clinical utility. Smartphone applications are tailored to facilitate various aspects of medical practice, including diagnosis, evaluation, patient education, and treatment [11]. They also enable the user to capture and share images, making them useful tools for clinical photography. Furthermore, the integration of instant messaging smartphone applications such as WhatsApp has been instrumental in facilitating communication and education among groups of medical students. These apps have been reported to increase student involvement, improve the feedback process, and enhance communication between students and teachers, contributing to a more interactive and engaging medical education environment [12].
Education: At 28, dedicated educational use highlights the students' focus on studies and utilizing their phones for online courses, medical apps, or other learning tools. The dedication to educational use among medical students is evident, with a notable 28% emphasizing their focus on utilizing smartphones for online courses, medical apps, and other learning tools. This highlights the significance of smartphones as educational aids and platforms for medical students. With the increasing trend of integrating smartphones into medical education, the availability of dedicated educational resources and applications is essential to optimize their learning experience [13, 14].
Medical students and junior doctors have shown a strong inclination towards utilizing smartphones for accessing educational resources, medical apps, and online courses. These tools supplement traditional medical education, provide interactive learning experiences, and facilitate access to various educational materials. Integrating smartphones as educational tools enhances the students' focus on their studies and promotes a dynamic and interactive approach to learning within the medical field [15].
As the utilization of smartphones for educational purposes continues to grow, the development of more educational apps and platforms that cater to the specific needs of medical students becomes increasingly imperative. The evolving landscape of smartphone applications for medical education signifies the transformative impact of technology on modern medical learning, promising an enriched educational experience and the cultivation of highly skilled medical professionals [16].
Behavioual Patterns in Smartphone usage
The study on smartphone usage and associated behaviors among undergraduate medical students at ABWA Medical College in Pakistan, detailed in Table 3 (SAS-Questionaire), offers an extensive look into the pervasive influence of this technology. The identified behaviors—spanning daily life disturbance, overuse, withdrawal, cyberspace-oriented relations, and tolerance—paint a picture of both the indispensable utility and the potential pitfalls of smartphone reliance. [17]
The study highlights different key points about the disturbance caused by smartphones in everyday life. One big thing is that students often need to remember to do their planned work because they spend so much time on their smartphones. This suggests a replacement effect where the use of digital devices makes real tasks less important [18]. The problem of not focusing in class or while doing homework due to smartphone disruptions shows users have broken attention. This is probably made worse by the nonstop floods of alerts and pull toward social media spots. Moreover, many students acknowledged using their smartphones for extended periods, surpassing their initial intentions, signaling a lack of self-regulation and potential addiction [19, 20].
Overuse of smartphones is characterized by physical and mental symptoms that significantly impact students' quality of life. Physical discomfort, including pain in the wrists and neck, aligns with prolonged smartphone use [7, 11]. Visual disturbances and sleep deprivation further contribute to a deteriorating physical state. The psychological aspect is equally concerning, with students expressing repeated, yet unsuccessful, attempts to cut down smartphone usage. This cycle of recognition and inability to change underscores the compulsive nature of their behavior, further validated by peers' observations of their excessive use [12].
Withdrawal symptoms manifest in the student's inability to disconnect from their smartphones. They feel anxiety or discomfort when they can't use their gadgets. The anxiety or discomfort experienced when unable to use their devices suggests a deep-seated dependency on digital connectivity [9]. The need to physically hold the smartphone, even when not in use, signifies an emotional or psychological comfort associated with the device's presence. This compulsive behavior is further evidenced by students' reluctance to reduce smartphone use despite acknowledging its detrimental impact on their daily lives. [13, 15]
The category of cyberspace-oriented relations reveals a profound shift in interpersonal dynamics, with students placing significant emotional value on their online interactions. Equating the inability to use a smartphone with the emotional loss of a friend demonstrates the depth of attachment to digital social networks [6]. The preference for virtual interactions over real-life contact indicates a transformation in social preferences, where some students find greater comfort or validation in online communities. The need for constant connectivity, driven by a fear of missing out, underscores an anxiety-driven compulsion to remain continually online [17].
Tolerance to smartphone usage is evident in how students interact with their devices over time. A fully charged battery does not last a day, which reflects not just intensive use but also desensitization, where increased usage is required to achieve the same level of satisfaction or functionality. When students' smartphone use is stopped, it shows how interactions on digital devices have become more important than quick real-world or social group situations [18].
The behavioral patterns identified through the study reflect a multifaceted relationship between students and their smartphones. While these devices serve as vital tools for information access, communication, education, and entertainment, the downside is a range of behaviors suggesting overreliance and potential addiction [3]. These behaviors have significant implications, including integration into almost every aspect of lifestyle, risk of addiction, shifts in social interaction preferences, as well as various negative physical and psychological effects [4, 5].
Understanding these behavioral patterns is crucial for developing targeted interventions and policies to promote healthier relationships with technology. This might include educational programs on digital literacy, incorporating breaks and mindful use into daily routines, and supporting students who show signs of problematic use [9]. As smartphones continue to evolve and integrate more deeply into academic and personal lives, balancing their benefits with the potential for addiction and negative impacts will be an ongoing challenge. The insights from this study contribute to a growing body of knowledge necessary for informed decision-making and behavioral change in the digital age. [13, 15, 20]
This study had several limitations. First, longitudinal associations between PSU and health behavioral and other risk factors cannot be determined due to the cross-sectional design of the Survey. Second, we did not collect detailed information on the pattern of smartphone use among the users, which would have helped interpret the complex relationship between PSU and SES and other factors. Third, measures on health behaviors were self-reported. Although self-reported smoking and alcohol consumption are widely used and valid, the potential of underreporting might reduce the strength of associations observed in this study.