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Effects of the COVID-19 Pandemic on Osteopathic Medical Students’ Screen Time

Journal: The Journal of the American Osteopathic Association Date: 2020/12, 120(12):Pages: e70-e72. doi: Subito , type of study: clinical trial

Full text    (https://www.degruyter.com/document/doi/10.7556/jaoa.2020.157/html)

Keywords:

clinical trial [658]
medical students [673]
osteopathic medicine [2071]
screen time [3]
USA [1728]

Abstract:

Statement of Significance: COVID-19 is a novel infectious disease that has led to the World Health Organization declaring it a pandemic in March 2020. Subsequently, osteopathic medical students were transitioned to an online form of learning. Studies have shown that an increase in screen time can predispose an individual to developing symptoms of Computer Vision Syndrome (CVS). CVS is a group of vision-related problems resulting from prolonged electronic screen use. Increased computer usage can lead to a decreased blink rate, placing individuals at higher risk of developing CVS, leading to likely reduced efficiency and productivity. Consequently, the transition to online resources for medical education may predispose medical students to developing CVS. Research Methods: This clinical trial was reviewed and approved by NYIT IRB (IRB number: BHS-1325). Participants were first and second year medical students matriculated at New York Institute of Technology College of Osteopathic Medicine. The study was conducted over one full academic year, with data collected on three separate occasions in August 2019, February 2020, and April 2020. For each of the three data collection times, students scheduled to meet in person with the research team to provide screen time data, gauge their visual acuity via a Snellen chart, and answer a questionnaire to screen for CVS symptoms. The amount of screen time was recorded using RescueTime, a program that provided quantitative data on how much screen time was spent on Apple and Windows devices. Participants downloaded RescueTime at the beginning of the study, and the screen time data was obtained during the 2nd and 3rd visits via reports that were exported from the application. Once installed, RescueTime silently ran in the background of their devices and did not interfere with the participant's normal activities. Documentation of screen time was automated, reducing the risk for human error if participants were to estimate their screen time. The application also allowed for screen time data to be exported via print or email. All data from the questionnaire was entered into REDCap, a secure web application and HIPAA-compliant database designed for clinical and translational research. Data Analysis: RescueTime was utilized to log participant data on their daily screen time usage. Average screen time was collected for the 9 months that the study was active (August 2019 to April 2020). Afterwards, statistical analysis was performed by a biostatistician to gather daily and monthly data on screen usage. Results: A total of 33 participants were enrolled in this study with 22 participants included in this analysis as a result of loss to follow up. The mean screen time for the month of August was 2.4 hours per student per day. While the average screen time for participants increased to 5.9 hours in September and decreased to 4.9 hours in October, there was a consistent, considerable increase to greater than 6 hours in the last 4 months of the study. The average daily screen time in February was 6.0 hours. COVID-19 restrictions were enacted during the second week of March; at the end of the month, participants had an average screen time of 6.5 hours per day. April was the last month recorded, with an average screen time of 6.8 hours per day. Specifically, when noting the differences between March and April, there was approximately a 4.6% increase in screen time usage. Overall, the average screen time per day for medical students ranged from 2.4 to 6.8 hours from August 2019 to April 2020. Conclusion: The results demonstrate an upward trend of usage in screen time among osteopathic medical students as the academic year progressed. Limitations included a small sample size and loss to follow-up with some participants. Additionally, the study protocol initially planned for a total of 3 visits; due to COVID-19 restrictions, all on-campus research-related activities were suspended prior to the participants’ 3rd visit. As a result, the final visit was done virtually and visual acuity testing was not conducted. The increase in screen time is not conclusively caused by the increased demand for screen time related to COVID-19 restrictions as there may have been increased demands due to workload, examination deadlines and/or other factors. The differentiation between such variables was not examined in this study. Due to COVID-19 restrictions, many students had to undergo a massive adjustment in education, lifestyle and routine. Significantly increased screen time is a potential product of such change and may have affected this population of students in terms of visual acuity and other CVS-related symptoms. For this reason, there is an increased need for the medical student community to take part in preventative measures and specific management, especially if medical education in the face of a pandemic such as COVID-19 continues to be implemented in an online format.


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