Benefits and Challenges of Digital Technologies in Health Professions Education: Insights From Nursing and Medical Radiologic Technology Students in Ethiopia

Abstract

Introduction

Digital technologies are increasingly integrated into health professions education. However, their use by students in low-income countries has not been extensively studied. In this context, the balance between using these tools to build clinical competencies and the challenges involved remains unclear. This study explored the utilization, perceived benefits, and challenges of digital technology in classroom and clinical placement learning among nursing and radiologic technology students.

Methods

A descriptive qualitative study was conducted among nursing and medical radiologic technology students at Addis Ababa University, Arba Minch University, and Hawassa University in Ethiopia. Semi-structured interviews were conducted between August 10 and September 25, 2025, with nineteen third- and fourth-year nursing and medical radiologic technology students. Interview transcripts were analyzed thematically.

Results

Three main themes emerged: Use and Application of Digital Technologies in Health Professions Education, Perceived Effects of Using Digital Technology in Health Professions Education, and Student-Recommended Solutions to Digital Technology-Induced Problems. The first theme, use and application of digital technologies in health professions education, included subthemes: digital technologies for theoretical academic learning and digital technology use in the development of clinical skills. The second theme, perceived effects of using digital technology in health professional education, included subthemes: advantages of digital technology utilization for learning in health profession education and drawbacks of using digital technology for learning in the health profession.

Conclusions

While digital technologies are increasingly used by health professions students to support theoretical learning and clinical skills, their influence remains limited by inadequate digital infrastructure, limited digital and AI literacy, and unregulated use. To ensure these technologies optimize health professions education, higher education institutions must strengthen digital infrastructure, integrate digital and AI literacy into curricula, and develop clear digital technology and resource usage guidelines for responsible academic use.

Introduction

Following the expansion of digital technologies (DTs), reliance on traditional learning resources, such as lectures and the use of printed textbooks, has decreased. ¹ In this study, DTs refer to the use of digital systems, tools, and devices that process, store, and transmit data in electronic form. ² This definition encompasses a wide range of technologies, including computers, smartphones, software applications, the internet, and emerging technologies such as artificial intelligence (AI). The introduction of new technology-assisted learning tools-including mobile devices, smartboards, tablets, laptops, simulations, AI, and virtual laboratories-has transformed education in higher education institutions (HEIs). ³ DTs are believed to improve learning by providing an immediate learning environment, rapid assessment and increased student involvement, effectively addressing the constraints of traditional learning resources.^4,5 The recently emerged technology in education, AI, is defined as software that employs machine learning algorithms trained on large sets of input data to produce various types of novel content—has rapidly advanced over the last years and allows users to perform specific tasks and solve problems that were originally accomplished by humans only. ⁶ The use of AI among university and students are rapidly expanding, with significant implications for teaching practices, curriculum design, and institutional policies regarding technology integration.^7-9

DTs are reshaping health professions education by enabling interactive and flexible learning, which allows students to engage with the material more dynamically compared to traditional methods. ¹⁰ Several studies have provided evidence of the significant role of digital technology in improving teaching, learning, and assessment, which positively impact students’ knowledge and skills in HEIs. ¹¹ Study showed that DTs offer benefits in enhancing clinical skills learning, building confidence for clinical practice-readiness, and promoting clinical skills acquisition. ¹² Another study indicates that online eLearning is equivalent to and perhaps even more effective than traditional learning in terms of knowledge and skills gained. ¹³ And another study revealed that DTs can maximize learning and support mastery of knowledge, skills and attitudes. ¹⁴ Technology integration can be used for shaping a future ready radiography curriculum. ¹⁵ The application of DTs for clinical skills training mainly demonstrated through online learning platforms, ¹⁶ simulation training,^17,18 virtual reality and augmented reality technologies. ¹⁹ . ²⁰

Although DTs have several advantages in the education of the health professions, they do not come without challenges. Higher education students navigate academic pressures, social transitions, and constant connectivity, which may affect their well-being in both positive and negative ways. ²¹ In addition, the emergence of freely accessible generative AI tools, powered by large language models, has raised renewed concerns within medical education with regard to plagiarism, academic integrity, and the responsible use of AI in learning. ²² Studies have shown that despite growing interest in AI, significant gaps remain in health professions education. Comprehensive strategies such as curriculum integration, faculty development, and ethical training are urgently needed to foster responsible, confident, and clinically relevant AI adoption among future healthcare professionals.^23,24

In addition, digital penetration is unevenly distributed across HEIs in different countries. ²⁵ According to the 2023 World Bank report, access to DTs like the internet, computers, and mobile phones remains low across Sub-Saharan Africa, with significant inequalities among socioeconomic groups. ²⁶ Similarly, several studies have identified many challenges in the use of DTs in Africa, including limited access to technology and the internet; low availability and reliability of the internet and digital devices; limited digital literacy; inadequate institutional support for technology-enhanced learning; and slow adoption rates among students and teachers.^27-29 A study conducted in eastern and southern Africa showed health professions students face challenges such as unreliable internet, limited access to digital devices, financial constraints, and technical issues with software and platforms. ³⁰

In Ethiopia, although there has been some adoption of various digital tools for teaching and learning, widespread integration remains limited. ³¹ Another study indicated concerns about internet accessibility, a reliable electrical power supply, and access to the necessary hardware for the successful integration of the DTs into Ethiopia’s higher education system. ³² Another study carried out in Ethiopia among health science students found that they experienced poor internet access and had limited digital skills. ³³ Despite these studies, the perceived benefits and challenges of DTs for health profession students remain underexplored. Furthermore, digital technology continuously challenges health profession educators to reevaluate how health profession students learn. Additionally, a study titled ‘Functions, Challenges and Opportunities of Health Professions Education Units in Africa: A Qualitative Study Across Eastern, Southern and Western Regions’ revealed that one area that requires further study is the use of digital tools to improve the work of health professions education units. ³⁴ Therefore, this study aimed to explore the perceived benefits and challenges of digital technology utilization among health profession students.

According to a study of digital education for health professionals, there have been few studies on DTs in health professions education, indicating the need for context-specific research. ³⁵ To maximize the potential of DTs for training health professions students, it is essential to assess and reassess their benefits and challenges. To support the process of optimizing health professions education, this study explored the perceived benefits and challenges of digital DTs in health professions education based on the following research questions:

• a) How do students in health professions perceive the challenges associated with using DTs for learning?

• b) How do health professions students perceive the advantages of DTs for their learning process?

We believe that the findings of this study will serve as valuable input for higher education policymakers, curriculum developers, educators, and researchers in their efforts to transform health professions education.

Methods

Qualitative Approach and Research Paradigm

To address the research questions, a qualitative study design was used, and semi-structured interviews were conducted with 19 nursing and medical radiologic technology students from three selected universities in Ethiopia. Semi-structured interviews were used to gather data, and the questions aimed to determine the students’ perceptions of the benefits and challenges of DTs in their learning activities. The reporting of this study conforms to the Standards for Reporting Qualitative Research (SRQR) guidelines (Appendix 1). ³⁶

Researcher Characteristics and Reflexivity

All researchers demonstrated reflexivity at every stage of this study. The research was conducted using a collaborative approach, with a multidisciplinary team that included a health professional instructor and researcher (M.J.), an educational researcher (B.A.), and a health professions education specialist (T.T.). The health professional instructor and researcher (M.J.) was a content expert with experience in validating research data. The educational researcher (B.A.) contributed expertise in methodological design and data analysis. The health professions education specialist (T.T.) provided expertise in research data validation and analysis. All co-authors were free to express their opinions during project meetings and communications.

Study Setting

The study was conducted at three purposively selected Ethiopian universities: Addis Ababa University College of Health Sciences, Hawassa University College of Medicine and Health Sciences, and Arba Minch University College of Medicine and Health Sciences. Selection was based on their established health sciences programs, different geographical location, and integration of digital infrastructure into health professions education.

Recruitment of Participants

To achieve the objectives of this study, purposive sampling was employed to select students who began their clinical placement during the study period. Consequently, both third- and fourth-year nursing and medical radiologic technology students were included. An invitation to participate in this research project was sent to all third- and fourth-year students through their social networks between the month of August and September 2025. There were no specific exclusion criteria based on gender, age and level of digital technological proficiency. Six students from Nursing and Eight students from medical radiologic technology expressed their interest participating during the first week of the study. The semi-structured interview, transcription, translation and data analysis then started. ³⁷ The participation invitation was resent, and both maximum variation sampling and opportunistic sampling techniques were used until data saturation reached. ³⁸ After nineteen participants were interviewed, data saturation was reached. The participants’ demographics are summarized in Table 1.

Table 1.

The Characteristics of the Nineteen Participants Enrolled in This Study

Institution		Addis Ababa University		Arba Minch University		Hawassa University
Sex		Male	Female	Male	Female	Male	Female
Field of study	Medical Radiologic Technology	3	1	2	2	1	3
	Nursing	1	​	1	1	3	1
Total		4	1	3	3	4	4

Data Collection

The study received ethical approval from the Institutional Review Board of the Institute of Educational Research, Addis Ababa University (IRB Approval: IER-IRB-0019/2025). The interviews began on August 10, 2025, and concluded on September 25, 2025. The data collector distributed study invitations through the students’ respective social network groups. Interested participants then contacted the researcher directly to schedule an interview, which was conducted and audio-recorded. To minimize the influence of relationship recruited from the three universities and has no prior and current relationship on the responses, interviewers who had no prior relationship with the participants were recruited. Participants were interviewed in their preferred language (two in Afaan Oromo and the remaining in Amharic). The interviews were semi-structured and guided by an interview protocol (Appendix 2). The questions aimed to explore students’ perceptions of digital technology utilization (Appendix 3). Each session lasted between 5 and 30 minutes. The interview duration varied from participant to participant; some participants raised issues that require additional probing questions, while even the shortest interview provided important insights and were included in the study. During the interviews, participants were asked about their use of DTs for educational purposes, whether they employed such technologies during clinical placements, their perceptions of using digital tools to develop clinical skills, the challenges they encountered, and whether they had utilized AI technologies in their learning. Verbal consent was obtained from all participants before the interviews. Interviews were conducted either face-to-face or by telephone, recorded, and subsequently transcribed. Sampling continued until data saturation was reached. ³⁹ Then, interviews from nineteen participants were transcribed verbatim and translated into English. A thematic content analysis was performed. Initial themes were identified by the corresponding author and independently reviewed by two additional researchers using a sample of transcripts. These early themes were refined and interpreted through the conceptual lens of self-directed learning.

Data Analysis

Researchers employed qualitative content analysis,^40,41 and conducted a thematic analysis of the interviews to explore nursing students’ practices, perceived value, and challenges regarding the use of DTs in classroom learning and clinical practice. Data from the semi-structured interviews were analyzed using thematic analysis, following the coding manual for qualitative researchers by Johnny Saldaña. ⁴¹ The audio recordings were transcribed verbatim and translated into English by the researchers. The verbatim transcripts prepared by the investigator (M.J) were reviewed by a co-investigator (T.T) to ensure accuracy, and subsequently checked again by another co-investigator (B.A). Each semi-structured interview was recorded, transcribed, translated, and analyzed promptly before proceeding to the next interview. All statements from the verbatim transcripts relating to participants’ perceptions of using DTs in their learning were manually and independently coded by each research team, ensuring data triangulation. Data analysis was conducted across four levels: codes, categories, sub-themes, and themes, which were applied as appropriate for coding. ⁴¹ Codes, categories, and themes were iteratively formulated and refined throughout the research process, with the active participation of all researchers. The team held five meetings to transcribe, translate, code, categorize, and theme the data, and transcripts were coded based on the research objectives. All authors participated in translation to enhance accuracy and reduce loss of the message. And also, multiple trustworthiness strategies were also implemented including investigator triangulation, and member checking.^42,43

Techniques to Enhance Trustworthiness

The study team used a systematic and coordinated strategy to ensure the analysis’s trustworthiness. After reading each transcript several times to fully comprehend the perspectives of the participants, the primary coder developed an initial table of codes categorized using an interpretative method. ⁴⁴ In parallel, two other members of the research team independently and manually coded the transcripts using the same approach. The team then met to compare interpretations, discuss discrepancies, and refine the coding. A table was created to organize individual codes into the categories previously discussed, allowing the identification of emerging themes and relevant sub-themes with associated quotations. Themes and sub-themes were further reviewed against the research objectives through successive discussions until consensus was reached.

Results

Three major themes were emerged from nineteen semi-structured interviews. These themes included the Use and application of DTs in health professions education, perceived effects of using digital technology in health professional education, and Student-Recommended Solutions for effective Digital Technology enhanced education. From our data analysis, subthemes emerged from some of the main themes, and categories were merged within some of the sub-themes (see Table 2). Comparative patterns between nursing and medical radiologic technology (MRT) students were integrated throughout the analysis.

Table 2.

Identified Themes, Subthemes and Categories From Health Professional Students at Addis Ababa University, Arba Minch University and Hawassa University Regarding Student Dependency on DTs and AI in Health Professional Education

Theme	Subtheme	Category
Use and application of DTs in health professions education	DTs utilization in theoretical academic learning	​
	Use of DTs in the development of clinical skills	​
	Perceived barriers of digital technology utilization	​
Perceived Effects of Using Digital Technology in Health Professional Education	Benefits of using digital technology in health profession education	​
	Perceived drawbacks of using digital technology for learning in the health profession	Over-reliance and diminished critical thinking abilities
		Perceived distraction and misuse
		doubts regarding the accuracy of AI
		Supervisors’ and patients’ perceptions of the use of DT in clinical settings
		Perceived excessive digital technology utilization on student’s health Concern
Student-Recommended Solutions for effective Digital Technology enhanced education	​	​

Theme 1: Use and Application of Digital Technologies in Health Professions Education

Nearly all participants reported using DTs in their learning. They described employing DTs both for studying theoretical content and for developing clinical skills during their undergraduate training. The integration of DTs into their daily learning was discussed in several ways, which are outlined in the subsequent sub-themes.

Subtheme 1: Digital Technologies Utilization in Theoretical Academic Learning

Digital technologies were extensively utilized by nursing and medical radiologic technology students for theoretical learning. Most reported using Google Search and YouTube to gain a deeper understanding of topics not fully grasped in class, to access new research, and to consult up-to-date guidelines. Several participants also emphasized their frequent use of AI tools, such as ChatGPT, to assist with assignments, elaborate on complex concepts, and support research projects.

The majority of participants stated that they used a digital tool or resource to better comprehend topics that they find confusing. This implies that individuals actively look for more information when confronted with topics that are ambiguous. They also used these tools and resources resource to complete their assignments. This indicates that the tool is not only for clarification but also serves a practical purpose in their academic or work-related tasks.

A participant from nursing department described how they relied on DTs for clarification, noting:

“Things I don’t understand… I use Google or AI.” (HNY31)

Another nursing student explained:

“We use YouTube to check things we didn’t understand.” (AMN31)

Medical Radiologic Technology Students Mentioned

“I watch Indian lecturers’ YouTube… explanations are clear.” (AAR31)

“I use AI as an assistance for doing assignments and for my research project.” (AAR41)

The majority of the participants highlighted the critical role of current information and established guidelines in health professions education. They emphasized that having access to the most recent data and clear instructions is essential for the health professions learning process and for ensuring effective and safe practice. This is because healthcare constantly evolves with new research, treatments, and public health concerns. They mentioned that digital tools and resources enabled them to access up-to-date information and guidelines. Both nursing and medical radiologic technology students reported using digital tools and information to obtain access to up-to-date information and guidelines.

“DTs provide up-to-date information and guidelines, which are very important for learning health sciences.” (HN41)

“Digital tools provide up-to-date information and guidelines, which is very important for the health sector.” (AAUR41)

Subtheme 2: Use of Digital Technologies in the Development of Clinical Skills

The majority of this study participants across disciplines and institutions believed that digital technology was essential for building clinical skills. They explained that they watched videos to observe how different procedures are performed, practiced by simulating patient interactions, and used digital tools to refresh their memory while in clinical settings. During clinical attachments, students reported using their smartphones to look up information they did not understand and to access digital records, such as patient histories, through computers.

Participants emphasized that learners should actively build their clinical skills, with DTs acting as supporting tools. They described different methods for learning or improving skills can be nurtured by watching dedicated videos. This approach allows for learning through digital tools, helping to build confidence and competence before interacting with actual patients.

Nursing students from Hawassa University explained the scenario as;

“Clinical skills are not just about what we see. It's not just about what we see in the hospital or different places, but we should develop ourselves. We can watch videos, practice by watching those videos, and practice by assuming a patient is next to us.” (HNY31)

“It prepares you for real clinical scenarios.” (HNY32)

“Using digital technology is necessary to find out how to perform certain procedures and to develop our clinical skills.” (HNY42)

Another nursing students from Arba Minch University mentioned;

“When we are with a patient, there might be things we don’t understand. I mean, since we are beginners, many things come up that are beyond us. So, we use smartphones to refer to those things.” (AMN31)

A medical radiologic technology student from Arba Minch University described;

“For instance, we encounter patient positionings that we were not taught in the class. We see online this kind of positioning.” (AMR31)

“I see videos and easily understand procedures. We also get skills from it. It is very helpful in developing clinical skills.” (AMR42)

A nursing student from Addis Ababa University mentioned;

“It is very necessary. Since we are in the health science field, we have different procedures. Before going to the clinical setting, we should look up the procedures. We can also watch videos to see how they are done. When we are in the clinical setting, sometimes we might forget, so we can use them to refresh our memory.” (AAUY41)

At the same time, participants acknowledged the limitations of using DTs in clinical skill development.

A medical radiologic technology students expressed their concerns on drawbacks of DTs in digital skills development.

“DTs are useful to prepare health professional students for real clinical scenarios, but not enough.” (AMR31)

“If completely depend on the digital resources it become dangerous. It will affect every aspect of the health professions education including clinical skill development.” (AAR31)

Subtheme 3: Perceived Barriers to Digital Technology Utilization

Participants discussed the barriers that they encountered in utilizing DTs for their learning purposes. The main barriers identified were limitations in information technology infrastructure and persistent internet connectivity issues.

Most participants from Hawassa and Arba Minch University mentioned that there is limited access to computers in the digital library, personal computers, and tablets challenge their effective use of DTs.

Participants from Hawassa University discussed as;

“The tools we use to access these DTs should be made available in adequate numbers to students. For example, computers, tablets, or smartphones should be stored in a library in adequate numbers.” (HNY31)

“…we need a device to use, no matter what, even if we have internet, we need devices. And I think smartphones, PCs, and various things are the biggest challenges.” (HNY32)

“Sometimes, my phone is not fast enough, and I don’t have enough data, which is a bit difficult.” (HNY41)

Participants from Arba Minch University mentioned;

“…lack of the device also another challenge…” (AMR32)

“Well, not everyone might have digital devices.” (AMN31)

“… I need laptop but I could not access and cannot buy.” (AMR42)

Participants of this study repeatedly identified poor and unreliable internet access as the most significant barrier. These issues were most frequently raised from participants from Hawassa and Arba Minch universities.

Participants from Hawassa Universities mentioned the internet connectivity problems as;

“When I use digital tools, the main challenge I face is the lack of network access.” (HNY31)

“I think the challenge is the internet problem. Internet access is not available everywhere; that is known. Internet access is the key.” (HNY32)

“…lack of internet is another problem.” (HR31)

Participants from Arba Minch university discussed the internet connectivity, and access problems;

“…we do not have internet access everywhere.” (AMR41)

“…The lack of internet also affects my learning.” (AMR42)

“Well, there needs to be network access. I mean, it would be nice if there was Wi-Fi in every room; not everyone buys data.” (AMN31)

Theme 2: Perceived Effects of Using Digital Technology in Health Professional Education

The use of DTs in health professions learning created clear tensions in the user experience. Although the vast majority of students stated that DTs significantly decreased the effort needed to reach their individual academic goals, they also expressed a great deal of pressure over the unintended behavior these tools encouraged. The data analysis resulted in two separate subthemes. Sub-themes and categories that emerged from each sub-theme are described below.

Subtheme 1: Benefits of Using Digital Technology in Health Profession Education

The advantages of DTs in the educational process were clearly articulated by participants from both departments across the three universities. They emphasized that DTs are particularly valuable for delivering quick and easily accessible information. Participants also believed that these tools can democratize access to specialized knowledge and help overcome regional educational barriers. Mobile devices were repeatedly praised for their efficiency and convenience compared to traditional libraries.

Nursing participants discussed the potential benefits of DTs:

“One of the advantages of DTs in learning is that they are fast for information searching.” (HN41)

“Now that everything is on our phones, we don’t need to visit large libraries to locate large books and other items.” (AMN31)

“An instructor might teach for three or four hours, but if we go deeper and explore, we can study for up to 10 hours; that is our effort. We can follow things to the end.” (HN32)

Participants also highlighted the role of DTs in connecting them to the global community. For instance, Participant AAR31 shared, “I follow international mammography WhatsApp groups,” while Participant AMNY41 mentioned, “We can connect and share via Telegram.”

Overall, the primary benefits of DTs were described as accessibility and speed of access. These tools were considered fast, easy to use, and effective in helping students gain deeper knowledge beyond local teaching, access up-to-date information, and ultimately improve their skills.

Subtheme 2: Perceived Drawbacks of Using Digital Technology for Learning in the Health Profession

Participants felt that there were several drawbacks despite the usage of DTs in health profession education. These drawbacks were categorized as over-reliance and diminished critical thinking abilities, distraction and misuse, doubts regarding the accuracy of AI, supervisors’ and patients’ perceptions of digital technology use in clinical settings, and health concerns. These perceived drawbacks were widely discussed among both nursing and MRT students across the three universities.

Category 1: Over-Reliance and Diminished Critical Thinking Abilities

A major disadvantage identified by majority of the participants was the risk of over-reliance on DTs for their learning. They explained that excessive dependence on digital tools and resources could hinder reading ability, critical thinking, creative problem-solving, and self-development. Participants believed that regular use of DTs for learning reduced their intellectual independence.

Medical radiologic technology students discussed this issue as:

“…Unfortunately, what we get from the internet is a brief explanation. It creates dependency on internet.” (AMR41)

“It kills self-independence. It creates dependence.” (AAR31)

Nursing students also described this issue;

“If used improperly, it destroys us” (AMN31).

“When we rely too much on them, our reading and thinking abilities can be hindered.” (HN41)

“They can cause dependency. When we rely too much on them, our reading and thinking abilities can be hindered.” (AAUN41)

Additionally, continued over reliance on DTs in health professions education was perceived to systematically degrade essential interpersonal interactions between students and instructors:

“If the student is 24/7 dependent on it, very dependent, I think we will lose interaction. I believe the interaction we have with the instructor and people will be limited.” (HN32)

Category 2: Perceived Cause of Distraction and Misuse

Another disadvantage of utilizing DTs in health professions education is distraction and misuse. According to participants, social media notifications and multitasking impaired their ability to focus on their studies.

“…for instance, it distracts me when I am studying. While studying I may open some social media, this distract me. I tried to restrict social media notifications; however, I do not do it all. when, you use only book for reading there is no distraction. but using mobile distract a lot. the challenge is this.” (HR41)

“I open to read but end up on social media.” (AMN31).

“We use social media; bad things are shared, and it kills time and distracts us.” AAR42

Category 3: Doubts Regarding the Accuracy of AI

Most of this study participants mentioned that they use digital tools to access AI out information for their learning. The majority of them pointed out flaws and inconsistencies in AI-generated content. They noted that the information obtained from AI out puts was often neither reliable nor complete.

“AI tools have a devastating effect on education. They make dependent. they are not reliable. They give us artefact.” (AAR42)

“AI does not give full information.” (AMR31)

Participants routinely identified using AI to detect and find differential diagnoses may not be as accurate as we want. This lack of accuracy was viewed as having a significant impact on patient management.

: “You know health is sometimes subjective and emotional. using AI and other to detect and find differential diagnosis may not as accurate as we want. This causes a huge impact on patient management. Therefore, if we become AI dependent, we are going to give false decision (Diagnosis).” (AAR31)

“We have to refer to standard text book. However, students are more prefer to use AI. This may mislead us.” (AAR41)

“The idea of the advantage of using AI in health profession education is not well-developed.” (HNY32)

Category 4: Supervisors’ and Patients’ Perceptions of the Use of DT in Clinical Settings

The majority of participants also mentioned their fear of patients’ and clinical supervisors’ reactions to the use of digital technology in clinical practice. When students use smartphones in clinical settings, they frequently encountered negative attitudes and misunderstandings from supervisors, who sometimes believed they were playing on Facebook. Students reported that supervisors and patients often perceived smartphone use in clinical areas negatively, assuming misuse or a lack of professionalism.

“Most of the time I do not use my phone during clinical practices; the supervisor may consider it as if I am doing other things.” (HR32)

“Most of the time, they view it negatively. Especially when it is patients, they think, “I am sitting here” or “I am here” and “she is playing on Facebook” or something like that. Even with teachers, a misunderstanding can occur. Like, unless they ask and see what it is, or unless they see it, most people think we are just using it for fun. And a little misunderstanding happens there.” (AMN31)

“I'm afraid of opening and reading learning materials in front of patients. It may deteriorate my confidence. The patients may consider me careless if I am scrolling my phone at clinical practices” (HR42).

Category 5: Perceived Excessive Digital Technology Utilization on Student’s Health Concern

Most of the participants highlighted that the frequent and excessive use of DTs could negatively affect their own health. The most of interviewees mentioned eye strain as one of their major health concerns.

“The other thing is if you always use digital technologies, it may affect your sight.” (HR41)

“There is a harmful side… if we use them excessively… they can be harmful.” (HN31)

Theme 3: Student-Recommended Solutions for Effective Digital Technology Enhanced Education

Students advocated proactive, multifaceted solutions to strengthen digital technology integration. Foremost among these was expansion campus-wide, high-speed Wi-Fi to ensure ubiquitous access. Institutional provisions like equipment loan schemes, dedicated computer labs, and subsidized devices would mitigate access disparities. Pedagogical enhancements include mandatory training on digital literacy, discerning AI use, and strategies to curb dependency—such as guided workshops emphasizing verification of AI outputs. Students advocated proactive, multifaceted solutions to strengthen digital technology integration. Foremost among these was the expansion of campus-wide, high-speed Wi-Fi to ensure ubiquitous access. Institutional provisions such as equipment loan schemes, dedicated computer labs, and subsidized devices were viewed as essential to mitigating access disparities. Pedagogical enhancements included mandatory training on digital literacy, discerning use of AI, and strategies to curb dependency—such as guided workshops emphasizing the verification of AI outputs. Finally, participants emphasized the importance of fostering disciplined, balanced use through policy guidelines and faculty modeling, prioritizing enhancement over prohibition in order to harness the transformative potential of DTs.

“What I think should be done is: The tools we use to access these digital technologies should be made available in adequate numbers to students. For example, computers, tablets, or smartphones should be stored in a library in adequate numbers. (HN31)

“Wi-Fi should be available everywhere, not just in the library” (HNY32)

“Well, it would be good if there was smartphone access for students; for example, it could be at a discount.” (AMN31)

“I think there should be trainings on the advantages and disadvantages of digital technologies, and make it available institutionally.” (HR31)

Discussion

This qualitative study aimed to explore students’ the experiences and perceptions of the benefits and challenges of digital technology utilization in health professions education. The findings revealed that DTs are actively utilized by students for learning purposes, specifically for clarification complex topics, completing assignments, and supporting clinical skills development. Students also acknowledged that although DTs are important for clinical skills acquisition, they cannot replace the traditional way of learning clinical skills. They also identified challenges of using DTs including distraction, overreliance, misuse, unreliable AI outputs, and health concerns such as eye strain and headaches. Finally, students suggested that balanced integration of DTs into teaching and learning is necessary to ensure they enhance education rather than undermine professional competence.

This study found that most students used DTs, particularly google search, YouTube, and generative AI, for learning theoretical content and the developing clinical skills. These findings are consistent with previous studies which reported that DTs are widely used among health professions students.^10,45-47 Students’ extensive use of these platforms suggests an increasing dependence on self-directed learning, in which students independently identify learning needs, identify information, and use available resources. ⁴⁸ Students used DTs to get clarifications on the topic of their interest, complete assignments, and used to develop their clinical skills.^49-52 This pattern suggests that DTs have increased students’ opportunities to control the timing, pace, and sources of their learning. Although proper utilization of self-directed learning requires adequate preparedness of educators, for students to properly engage and build self-directed learning skills, these skills lack in Ethiopia, as students reported distraction, overreliance, and misuse. ⁵³ Thus, access to information alone does not ensure effective self-directed learning; students also need the capacity to judge the relevance, accuracy, and credibility of information and to determine when digital resources are insufficient. A previous study found that, while the use of DTs provides numerous benefits in health professions education, the traditional learning methods like group seminars and face-to-face lectures remain popular because they allow for real-life interaction with peers and faculty, which digital methods cannot easily replace.^54,55 Our findings expand on this finding by signifying that student themselves identified the limitations of DTs for developing hands-on clinical skills. This study consistent with the systematic review on digital learning of clinical skills and its impact on medical students’ academic performance, which stated that integration of traditional and innovative digital teaching methods provides the most comprehensive learning experience. ⁵⁶

One of the most significant issues reported by students linked with the usage of digital technology was distraction. Similarly, a study on digital distraction and disinformation found that the usage of DTs increased the potential for distraction, making it increasingly difficult for students to focus on important tasks. ⁵⁷ Swedish medical students have also identified distraction as a disadvantage of digital technology use. ⁵⁸ It is understandable that many students have struggled to self-regulate their academic learning in an era where digital technology is a continual source of distraction. ⁵⁹ From a self-regulated learning perspective, effective digital learning requires students to plan their learning, monitor their attention and understanding, control distractions, and evaluate their learning outcomes. A recent systematic review on ‘Self-Regulated Learning in the Digital Age’ mentioned that learning management system, massive open online courses, AI, collaborative platforms, and learning analytics support self-regulated learning by providing personalized feedback and facilitating autonomous learning. ⁶⁰ Therefore, the distraction reported by students may show not only a digital technological challenge but also a need for clear development of self-regulation learning strategies. DTs can facilitate learner autonomy, but this autonomy is unlikely to be effective when students lack the metacognitive skills required to manage digital environments.

In addition to distraction, students identified several drawbacks of using DTs for learning such as overreliance on digital technology, reduced critical thinking, and unreliable AI generated outputs. Similar concerns have also been reported in recent studies. Previous studies have shown that overreliance on DTs and resources can hinder reading ability, critical thinking, and self-development.^61,62 Similarly, a recent study highlighted the significant risk of overreliance on AI, which may undermine students’ ability to think independently and critically. ⁶² Importantly, however, the findings do not suggest that DTs or AI inherently reduce critical thinking. Rather, the concern appears to be related to how these technologies are used. Study found that interactive scenario-based e-learning nurture active learning and critical thinking. ⁶³ Students in this study raised concerns that overdependence on AI generated information may reduce their capacity to retain and internalize knowledge, a finding consistent with previous studies.^64,65 Similarly, research has shown that the use of AI in medical training could produce professionals less capable of independent problem solving and critical evaluation than their pre-AI counterparts. ⁶⁶ Historically, clinical reasoning and diagnostic challenges were deliberately incorporated in health professions education to develop critical thinking and problem solving skills.^67,68 Accordingly, the role of AI should be positioned as a tool that supports clinical judgement rather than substitutes for the cognitive processes through which professional competence develops.

This concern aligns with previous studies indicating that students question the reliability, accuracy, and ethical implications of AI generated information for educational purposes.^65,69,70 Furthermore, overreliance on digital tools or AI assistants for clinical decision-making may lead to automation bias, resulting in patient harm when health professionals place greater trust in AI-generated recommendations than in their own clinical judgment.^71,72 This presents a crucial educational challenge for students getting ready for clinical practice: digital and AI literacy needs to go beyond technical skill to incorporate critical evaluation, information substantiation, limitation recognition, and ethical decision-making. Interestingly, this study also identified the need for higher education policies promoting the balanced and ethical use of AI in education, a recommendation that is supported by previous studies.^22,73,74 Recent study further argues that, that in today’s digital, interconnected, and rapidly changing world, modern critical thinking should integrate adaptability, creativity, and the ability to evaluate diverse resources, especially in complex, ambiguous, and data rich environments. ⁷⁵ As a result, the educational approach should prioritize strengthening students’ ability to question, verify, comprehend, and utilize digital information rather than merely increasing their access to it.

Participants in this study reported that clinical supervisors and patients often perceived smartphone use in clinical settings negatively, assuming misuse. This finding aligns with previous studies showing clinician and patient concerns that mobile device use might signal inattention or unprofessional behavior.^76,77 Specifically, some physicians expressed concern that students were distracted from learning when using mobile devices, while patients worried that these devices diverted health professionals’ attention away from their care. ⁷⁶ This finding underlines a sociocultural aspect of digital technology use that may be exclusively important in clinical education: the educational role of smartphone use is not always clear to patients or supervisors. As a result, students may face a tension between using digital resources to help learning and keeping professional expectations for attentiveness and patient interaction. When supervisors are unfamiliar with the educational applications of DTs, students may be disproportionately penalized or stigmatized for using these tools, even when they are employed to support learning and clinical decision-making. It may be possible to differentiate between appropriate smartphone use in clinical settings and intentional educational technology use thru clear communication, institutional guidelines, and supervisors training.

Participants further identified eye strain and headaches as health-related concerns associated with intensive digital technology use. Similarly, mentioned that screen-time-related eye strain is among ongoing health effects of using technology. ⁷⁸ Another study showed that spending more than four hours per day on the internet is a significant risk factor associated with increased headache severity. ⁷⁹ Similarly, a study has confirmed that the severity of internet addiction is associated with the severity of the headaches and insomnia. ⁸⁰ Eye strain and headaches are digital fatigues and manifested through cognitive overload, which can impair students’ academic performance.^81-83 In addition, studies show that digital Fatigue consistently reduced motivation, concentration, and academic engagement while elevating burnout risk. ⁸⁴

Another significant aspect of students’ experiences was the institutional setting. Students identified inadequate information technology infrastructure, limited access to computers in digital libraries, and poor and unstable internet connectivity as significant obstacles to using DTs for education. These challenges reflect wider inequalities in digital access. ²⁵ According to UNESCO (2023), Sub-Saharan African countries consistently rank low in access to technology compared to other regions. ⁸⁵ Studies in the African context have similarly identified limited access to technology and the internet, unreliable devices and connectivity, digital literacy gaps, inadequate institutional support, and slow adoption of technology-enhanced learning among students and teachers.^28,29 This implies that students’ ability to use these technologies is influenced by the accessibility, affordability, reliability, and quality of digital infrastructure.

This institutional dimension is especially significant given the Ethiopian situation. Students reported extensive use of DTs, particularly Google Search, YouTube, and generative AI, to clarify complex concepts, complete assignments, and support clinical skills development. Widespread use of digital technology among students in Ethiopia was reported in a previous study. ³³ Students described significant institutional barriers, including inadequate ICT infrastructure, limited access to computers, and unreliable internet connectivity, which constrained their ability to effectively utilize DTs for learning. They mentioned that DTs should supplement, rather than replace, traditional clinical teaching methods, especially for hands-on clinical skills acquisition. A study on the digitalization of higher education in Ethiopia found that poor internet connections and insufficient ICT infrastructure were major barriers to advancing digitalization in Ethiopian universities. ⁸⁶ Another Ethiopian study revealed that institutional factors also hindered the integration of digital tools into higher education learning. ³¹ A recent study assessing the readiness of Ethiopian HEIs to adopt AI identified technical, organizational and administrative challenges as the main obstacles to adopting AI. ⁵³ These challenges imply that limited access to DTs, lack of training, policy and governance significantly impacts the ability to harness the benefits of digital tools and information. Overall, these findings suggest that while DTs have significant potential to enhance health professions education in Ethiopia, exploiting their benefits requires improved digital infrastructure, the promotion of self-regulated learning and critical thinking skills in the digital age, ethical AI use, faculty awareness of educational technology, and institutional policies that support the balanced integration of DTs into teaching and learning.

Limitations

This study has several limitations. First, because participants were aware of the interviewer’s presence and audio recording, social desirability bias may have influenced their responses. Second, the study’s transferability is limited by its small sample size and localized scope—conducted across three Ethiopian universities and two health disciplines. Although data saturation was reached (aligning with qualitative research goals that prioritize depth over breadth), the findings may not capture the full spectrum of experiences across other institutions, regions, or programs. Third, as a descriptive qualitative study, it cannot establish causal relationships between digital technology use and outcomes such as clinical reasoning or patient safety. Finally, the study did not systematically track specific digital applications, AI versions, or usage frequency and duration, limiting the ability to quantify exposure or replicate the exact conditions.

Conclusion

This qualitative study of nineteen Ethiopian nursing and medical radiologic technology students found that DTs are widely used to support theoretical learning and clinical skills development. However, their effective utilization is limited by digital infrastructure, lack of digital literacy, and unregulated use. Students reported that unregulated and unethical use of DTs and resources led to overreliance, which may impact their critical thinking abilities, cause distraction, create dependency on unreliable AI generated information, and impact their own health. On the other hand, they emphasized that DTs serve as powerful learning enablers only when availability is balancing with robust institutional policy and intentional pedagogical approach.

Thus, HEIs should consider the following points:

• 1. Digital infrastructures and technical support: There must be a dedicated digital learning hubs equipped with uninterrupted connectivity, hardware, and ongoing technical support units to guarantee equitable access across campuses.

• 2. Curricular integration and policy: Academic leaders must incorporate clear digital and AI literacy courses into health professions curricula, supported by clear institutional policies on academic integrity, ethical AI usage, and digital assessments to mitigate distraction and misuse.

• 3. Faculty development and stewardship: Health professions educators require continuous training to strengthen their own technological competence, enabling them to act as stewards who foster ethical awareness, critical appraisal, and social responsibility among learners.

Although health professions students are at the forefront of AI and digital adoption, they currently navigate these tools without adequate institutional support. Bridging this gap through proactive policy frameworks will ensure technology enhances rather than undermines clinical competence. Future research should evaluate the longitudinal impact of emerging digital and AI technologies on health professionals’ core clinical competencies, patient safety, and broader healthcare delivery practices.

ORCID iDs

Marema Jebessa Kumsa https://orcid.org/0000-0002-6547-2936

Berhanu Abera Kibret https://orcid.org/0000-0002-6930-6054

Tefera Tadesse Jimma https://orcid.org/0000-0002-1770-4659

Ethical Considerations

The study received ethical approval from the Institutional Review Board of the Institute of Educational Research, Addis Ababa University (IRB Approval: IER-IRB-0019/2025).

Consent to Participate

Before participation, the researchers explained the study’s purpose and emphasized participants’ rights to refuse or withdraw without academic consequences. Informed consent was obtained, ensuring data privacy and confidentiality.

Data Availability Statement

The datasets used and/or analyzed during the current study available from the corresponding author on reasonable request.*