How Have Researchers Acknowledged and Controlled for Academic Work Activity When Measuring Medical Students’ Internet Addiction? A Systematic Literature Review

Abstract

Internationally, medical students’ Internet Addiction (IA) is widely studied. As medical students use the Internet extensively for work, we asked how researchers control for work-related Internet activity, and the extent to which this influences interpretations of “addiction” rates. A search of PubMed, CINAHL, Web of Science, Scopus, and Google Scholar was conducted on the search phrase of “medical students” and “internet addiction” in March 2020. In total, 98 studies met our criteria, 88 (90%) used Young’s Internet Addiction Test, and the studies’ IA rates ranged widely. Little note was taken of work-related activity, and, when discussed, had little to no impact on the interpretation of Internet “addiction”. Studies seldom accounted for work-related activities, researcher bias appears to influence their position, “usage” appears conflated with “addiction”, and correlations between “addiction” and negative behaviours are frequently confused with one-way causation. In spite of IA’s not being officially recognised, few researchers questioned its validity. While IA may exist among medical students, its measurement is flawed; given the use of the Internet as a crucial medical education tool, there is the risk that conscientious students will be labelled “addicted”, and poor academic performance may be attributed to this “addiction”.

Prevalence and Factors Associated with Problematic Internet Use among Ethiopian Undergraduate University Students in 2019

“…Being male, probable depression, and currently using khat or caffeinated drinks were significantly associated with PIU. The present study is in line with studies conducted in India [ 14 ], Pakistan [ 15 ], Japan [ 24 ], and the United Kingdom [ 37 ] among university undergraduate students, which had rates of 18.8%, 16.7%, 21.6%, and 18%, respectively. This consistency may be due to sharing of the same study population with the same age group used, as well as the use of the same assessment method (the IAT) to classify problematic Internet use.…”

“…A survey conducted in Asian countries like Japan, China, Pakistan, and India revealed rates of 21.6%, 26.7%, 16.7%, and 18.88%, respectively. The highest problematic Internet use risk profile is that of a male, under the age of 21, with low self-esteem who lives away from home, making him more vulnerable to problems and also to depression and anxiety [ 13 – 15 , 24 ].…”

Loneliness and problematic internet use: testing the role of interpersonal problems and motivation for internet use

“…For example, antisocial person may use Internet to accomplish illegal activities, to bully or cheat others, and to do illegal gambling [48]. In other occasions, motivation for studying should be considered especially when investigating PIU among medical students [49].…”

Personality Traits of Croatian University Students with Internet Addiction

“…However, this study demonstrated another important issue regarding IA in the university student population, and that is that 52.2% of students who mainly used the Internet for the fulfillment of their university assignments were considered addicted to the Internet following the used criteria meaning that the use of the Internet for required work is not easily separated from the use of the Internet because of an addiction. The described problem of the addiction versus reliance on Internet usage for required work in the university student population has been previously identified in the literature [ 58 ], and it is important to emphasize that the results of this study should be seen in the light of that problem, so that “addiction” among university students may not be as clear-cut as one might initially believe.…”