The cross-sectional, questionnaire based study was conducted in Department of Physiology, Datta Meghe Institute of Medical Sciences (Deemed University) which has a rural base although the students come from all parts of the world. The study population included students (n = 150) in I^st phase of medical curriculum. It was ethically approved and informed consent was taken from all the participants. Since this was a qualitative study, the participants were subjected to a validated survey questionnaire which had closed and open ended items. The internal consistency of closed ended items were calculated. The study population was briefed about the nature and purpose of study. The survey questionnaire was sought from all the 150 students. It focused on the perceptions and attitudes of students who have recently joined the medical school regarding the role and relevance of technology in higher education. The students were asked to self administer the questionnaire in a lecture class. Time allotted for the same was half hour. Since the completed questionnaire was collected pairing it with attendance record, fallouts were avoided.

The survey was followed by a structured focus group discussion (n = 10) of teaching faculty for 1^st year MBBS students. The participants of FGD were carefully matched for homogeneity. The selection of FGD participants were based on the balanced representation of faculty in terms of subject specialty, age, experience, cadre and involvement in teaching learning & evaluation (TLE) activities. The FGD, which lasted for two hours; was conducted by two faculty members, one as a facilitator (who was a trained faculty for conducting FGDs), and other who recorded the discussion verbatim. The FGD was an attempt to speculate the faculty’s attitudes and perceptions regarding ICT and its potential role in TLE activities. A prevalidated FGD guide was used for the said purpose [Table/Fig-1].

Data collection: A validated questionnaire and one focus group discussion (guide) which probed into the knowledge, attitude and extent of utilization of IT, was used for the study.

Quantitative data: Closed ended responses of 10 items in survey questionnaire through 5 point Likert’s scale

Qualitative data: Open ended responses of 5 items in survey questionnaire and excerpts of FGD

Data Analysis: Quantitative data was analysed by percentage distribution and Qualitative data by coding and categorization. The transcripts of the focus group were collated and categorized according to the areas identified in FGD guide. The transcripts were then analysed for trends, patterns and findings keeping into consideration the words, framework, internal agreement, precision of responses and major findings.

The survey questionnaire consisted of two parts:

Part A: Ten closed ended items on five point likert’s scale

Part B: Five open ended items

The questionnaire had ten closed ended items [Table/Fig-2] with internal consistency of 0.74, which dealt with the regular use of ICT among the sample population (n=150). 70% of students strongly agreed about their comfort and expertise with technology (item no. 1). The user friendliness of technology as a source of useful information was agreed upon by 88.88% of students (item no. 2). There was a mixed response about the awareness of authentic and reliable websites for information. In fact 26.98% chose to be neutral on this aspect and 12% disagreed for the same (item no. 3). Preference for web over text books was agreed by 39.68% students whereas 57.13% preferred text books over web (item 4 & 5). 57.13 % of them preferred to visit digital library (e-books, e-journals and entertainment) during free hours, whereas 39.67 preferred Central library (books & journals). 61.88 % students agreed that contents covered in classroom are readily available on internet [Table/Fig-2].

The students were asked to specify the time they devote to internet daily which 58.33% reported for 1-2hrs, 16.66% for half hr and more than 2 hrs on a daily basis and 8.33% occasionally [Table/Fig-3].

41.26% of students agreed that technology can replace textbooks in coming years. The reasons put forth are categorized into; (1) Technology as user friendly, (2) Techno savvy generation (3) Vast information available 4) Technology being interactive & personalized and 5) Environment friendly. However 55% students did not support the idea and emphasized that text books cannot be replaced because; (1) they are more reliable and give authentic information, (2) there is no dependence on electricity and (3) Unavailability / inaccessibility of technology [Table/Fig-4] is a limiting factor.

84% of students agreed that in our institute technology is being utilized optimally, 14 % felt that more graphics and animation should be added in T/L activities. One important comment was that laptops should be allowed in classrooms [Table/Fig-5].

The disadvantages of technology as a learning resource material is categorized into (1) Vulnerability to misuse, (2) Unreliable resource of information and (3) Technology/electricity failure. Few students emphasized its unreliability as an information source since it can be edited by anyone [Table/Fig-6].

71.03% of students were in favour of including technology training in their curriculum. They felt that this can help in better handling of vast information resource and also facilitate learning. 28.04% students did not deem it necessary as they felt that most of the things can be learnt by themselves as technology is quite user friendly [Table/Fig-7].

The most frequently visited sites were facebook (92%), google (91%), e-mails (87%), followed by Wikipedia, online shopping sites and you tube [Table/Fig-8].

Focus Group Discussion of Faculty supported the hypothesis of increasing dependence of IT amongst Medical Undergraduates (as depicted in [Table/Fig-9]).

Since the development of computer and evolution of the Internet, Information Technology (IT) has had a positive impact on health care delivery systems worldwide, particularly in the areas of disease control, diagnosis, patient management and teaching [14]. Internet, one of the key developments in this field, provides instant access to latest medical information [15]. The present Institution is a Deemed University which has an annual intake of 150 medical students from India and abroad. This study was conducted (i) to analyse the attitude about role of ICT among medical undergraduates (ii) to estimate the extent and purpose of ICT use among medical undergraduates and their perception regarding the need for incorporating computer education in medical curriculum. It was observed from the responses obtained that students were expert and extremely comfortable with technology. They unanimously agreed that latest technologies in computer application makes it extremely user friendly and easy. Almost 92% of them were surfing internet daily for atleast half to more than two hrs. Majority of them (57%) however preferred textbooks for medical information rather than internet. Open ended responses also supported this belief when probed; “Do you think technology can replace text books? Give reasons” to which 55% disagreed, regarding text books as more reliable, easily accessible and not dependent on electricity. This preference is in consonance with a similar study conducted by Banerjee et al., [15] which reported primary source of medical information as textbook for Under Graduates and majority of them stated internet as a ready source of information to save time. Another study by Nurjana et al., obtained a self-reported assessment of the use of ICT by medical students at the International Medical University, Malaysia. The survey revealed that 5.7% did not use computer either in the university or at home. It stated adequate skills at word processing (55%), e-mail (78%) and web searching (67%) [13] during leisure hours. This goes on to suggest that though learners seek information through technology as a ready and practical source; the relevance of text books and literature remain as a primary source for clarifying the concepts and holistic learning.

Our university has well established digital library with 70 terminals. It is always occupied with students if they have any free time or after scheduled lectures. The present study supported this observation indicating digital library as a preferred place during free hours where they can access internet readily rather than central (books and journals) library. The most frequently browsed sites were reported to be Facebook, Google, personal e–mails, You tube, Wikipedia, online shopping sites in the descending order. Central library facility was availed when they had forthcoming exams or when they had to prepare for seminars or presentations.

45% students felt that learning with the help of internet and computers will be a preferred method in future due to availability of vast information, interactive and personalized media, environment and user friendliness which is more appealing for the current techno-savvy generation. This brings forth an important aspect that there should be more emphasis on computers as standard tools for learning with more use ICT in classrooms. There should be emphasis on expansion of computer-assisted learning which requires careful strategic planning, resource sharing, staff incentives, active promotion of multidisciplinary working, and effective quality control [16]. Our student population has increased over the years and is likely to overwhelm the facilities if it were not for the use of IT enabling lectures, demonstrations and illustrations to be delivered to multitudes of students simultaneously. The introduction of a structured computer training course, which includes the applicability of IT to medicine, into the curriculum of medical students, health record students, residency and continuous medical education training (CME) programs would certainly assist in ensuring maximal utilization of the advantages offered by IT.

The present study revealed that students are more or less aware of the disadvantages attached to ICT as a reference source in terms of; 1. Vulnerability to Misuse, 2. Unreliable resource of information, 3) Prone to technology/electricity failure. In spite of the obvious disadvantages, students strongly felt that computer skills training is obligatory and should be a part of medical curriculum. The recommendation to include teaching of basic information technology to be integrated into medical studies is also served by many studies in recent past [15,17,18]. It justifies the need to incorporate internet and associated information technology into existing medical curriculum with a view towards increasing use and dependence on ICT as a ready reference tool in higher education. Similar were the recommendations by Malaysian study [10] which suggested formal inclusion of ICT instruction in the teaching of undergraduate medicine, to enhance medical students’ ability to acquire, appraise, and use information to solve clinical and other problems. A comparative analysis of the past studies and the present study is depicted in [Table/Fig-10].

The focus group discussion excerpts furthers the assumption that medical students are getting more and more influenced by technology as a ready source of information. Although, as an observation of faculties; it is the teachers/facilitators who actually influence students style of learning to a major extent. Nevertheless, the preferred learning style through ICT is becoming more and more dominant for coming generations. The faculties also support the idea of incorporating its basic training in medical curriculum, though they feel that it is more essential for staff than students. The faculties felt that they should receive a formal training about how to optimally use Information technology for better Teaching Learning activities.

With the qualitative data so obtained, one can safely determine that ICT use amongst medical students is a part of their daily routine. Most of the students actually depend on it for ready retrieval of information. They are proficient in using technology and feel that it should be a mandatory part of higher education curriculum not only to learn how to use it efficiently, but also to realize its fallacies and inadequacies.

There is a need to foresee the role of technology in education and take appropriate measures to equip the stakeholders for adequate and optimum application of the same. Incorporation of need based basic information technology training as a part of medical curriculum should be pondered upon. A judicious admixture of time tested and newer technologies in teaching learning should be emphasized to make learning an enjoyable and memorable experience. The study also generates a new hypothesis that in consonance with changing paradigms of technology as a learning tool; it becomes mandatory for the faculty to be well versed with technology so as to facilitate and guide learning through technology.