Attitudes and Experience of Paramedical Students Toward Telehealth in Education, A Cross-Sectional Study

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Paramedical students’ perspectives are key, as their readiness affects the future success of telehealth in clinical practice. Therefore, the aim of this study is to investigate the attitudes and experiences of paramedical students toward telehealth. Materials and Methods This cross-sectional quantitative study was conducted from October 2024 to February 2025. Data were collected using a previously validated questionnaire developed by Rettinger et al. (2024). The questionnaire consisted of 18 items that addressed demographic information, respondents’ ICT competence, interest in telehealth, perceived knowledge, the importance and applications of telehealth, previous telehealth experiences, and three open-ended questions exploring students’ perspectives on telehealth. The questionnaire was administered online. A survey link was emailed to eligible students who had expressed interest in participating. Completing the survey took approximately 15 minutes. To ensure validity, the face validity of the questionnaire was reviewed by five faculty members. Reliability was evaluated through the test-retest method over a 10-day interval, yielding a Cronbach’s alpha of 0.78. Data were analyzed using SPSS version 16. Results A total of 132 students responded to the survey (response rate: 100%). 72.7% of the students were very or relatively interested in telehealth. 77.3% considered telehealth important during their studies. However, only 11.4% reported actual experience with telehealth programs in their field. The Kruskal-Wallis H test showed significant differences across education levels in terms of perceived knowledge (P = .014) and perceived importance of telehealth in education (P = .042). Conclusion Despite high levels of interest and generally positive attitudes, students reported limited experience and exposure of telehealth. These findings highlight the importance of integrating telehealth education into paramedical training. Telehealth Attitude Experience Paramedical Students Figures Figure 1 Figure 2 Figure 3 Introduction Telehealth is defined as the delivery and facilitation of health and health-related services—including medical care, provider and patient education, health information services, and self-care—via telecommunications and digital communication technologies, using innovative methods such as online consultations, remote monitoring, and the provision of healthcare services (1). With remarkable advancements in technology, telehealth has become an integral component of modern healthcare, playing a significant role in improving the quality of medical services and facilitating access to healthcare (2–4). According to recent estimates, over 60% of healthcare institutions in the United States and nearly half of the hospitals utilize telehealth, underscoring its importance in increasing access to care, reducing costs, and enhancing patient experience globally (1). The World Health Organization (WHO) has also emphasized the importance of using information and communication technologies (ICT) in healthcare programs (5). Telehealth is particularly recognized for its ability to reduce geographic barriers and improve access to healthcare for underserved populations, such as those in rural and disadvantaged areas (6–8). The growing use of this technology highlights the need for telehealth education for healthcare providers (9). To successfully implement telehealth and leverage its benefits, integrating telehealth into the curricula of future healthcare professionals is essential (10). Notably, telehealth education for medical and nursing students began in the late 1990s, and many academic institutions have recently paid increased attention to this technology (11). However, one of the major challenges in telehealth adoption is the need for proper education in this area (12). A recent survey by the Association of American Medical Colleges (AAMC) revealed that currently only 58% of medical schools offer telehealth training (13, 14). This educational gap became more pronounced during the COVID-19 pandemic, when the need for telehealth became increasingly evident (15). Moreover, research indicates that a lack of knowledge and experience in telehealth is one of the main barriers to its adoption among students and healthcare providers (9). However, telehealth education can enhance confidence, preparedness, and acceptance of this technology (10, 16, 17). Despite its significance, formal telehealth education is still insufficiently incorporated into many academic programs (18, 19). Numerous studies have examined the educational needs and existing challenges in delivering effective telehealth training, including those highlighting the importance of leveraging modern technologies to improve healthcare quality and enhance students’ capabilities in utilizing such technologies (19). Additionally, recent studies, including those by Boos and Sabrina, have shown that experience-based educational modules can significantly improve students’ knowledge, attitudes, and confidence in using telehealth (20, 21). Two systematic reviews conducted in 2021 identified major deficiencies in the integration of telehealth into health and nursing curricula, such as lack of coherence, absence of clear standards, and a mismatch between educational content and actual clinical needs (22, 23). Therefore, a significant gap in the current literature is the lack of structured programs for telehealth education in Paramedical disciplines. Despite recent efforts to incorporate telehealth into education, most studies have focused on medical and nursing students, and there is limited information on the status of telehealth education and attitudes among Paramedical students. Accordingly, the aim of the present study is to explore the attitudes, experiences, and perceptions of Paramedical students at Mashhad University of Medical Sciences regarding telehealth. It is also worth noting that many studies, including the present one, assess students’ perceptions and understandings of the subject rather than actual competencies, which may not necessarily correlate directly with behavioral performance. Methods Study Design This cross-sectional quantitative study was conducted from October 2024 to February 2025. All ethical principles outlined in the Declaration of Helsinki were strictly adhered to (24). Accordingly, students were clearly informed about the objectives, procedures, potential benefits and risks, and possible discomforts related to the study. Participation was voluntary, and informed consent was obtained from all participants. As an incentive for participation, the objectives of the study were explained at the beginning of the questionnaire, and participants were informed that they would receive a general feedback on the results upon completion of the study. All personal information was kept confidential and anonymized for research purposes only. Sample Size The study population included all students enrolled in the School of Paramedical Sciences and Rehabilitation at Mashhad University of Medical Sciences during the 2024 academic year. These students were from eight disciplines: Health Information Technology, Laboratory Sciences, Optometry, Radiology, Speech Therapy, Occupational Therapy, Physiotherapy, and Social Work, and were studying at undergraduate, master’s, and doctoral levels. Stratified proportional sampling was employed: students were first categorized by discipline and academic level, and then a proportionate sample was selected from each stratum based on Cochran’s formula (with a confidence level of 95% and α = 0.05). The initial sample size was 87; however, to enhance accuracy and generalizability, a total of 132 participants were ultimately included. n = Number of samples required to carry out the design Z = The value of the statistic equivalent to the area under the standard normal curve P and q = The frequency ratio of the desired trait in the target population d = Effect size or precision Inclusion criteria were all students actively enrolled at the School of Paramedical Sciences and Rehabilitation at the time of the study. Exclusion criteria included transfer or visiting students from other universities, students on academic leave during data collection, international students, and those unwilling to participate. Participation was entirely voluntary and based on informed consent. Participants were assured that their information would remain confidential and be used solely for research purposes. Data Collection To evaluate students’ attitudes and experiences, a pre-developed standardized questionnaire by Retinger et al. was used (9). The face validity of the questionnaire was reviewed by five faculty members, and after incorporating their suggestions, the final version was approved. Its reliability was assessed using the test-retest method with a 10-day interval (Cronbach’s alpha: 78%). The questionnaire included 18 questions covering demographic data (age, gender, educational level, field of study), respondents’ ICT competence, interest in telehealth, perceived telehealth knowledge, importance of telehealth, various applications of telehealth, telehealth experiences, telehealth in education, and three open-ended questions exploring students’ perspectives on telehealth. The questionnaire was designed electronically, and an email with the survey link was sent to eligible students willing to participate. Two reminder emails were sent at one-week intervals. Participation was voluntary, and responses were anonymous. Interest in telehealth was rated on a 5-point Likert scale (1 = not interested, 2 = slightly interested, 3 = somewhat interested, 4 = very interested, 5 = no opinion). Perceived knowledge of telehealth was assessed by choosing one of five statements ranging from never having heard of telehealth to knowing many of its applications professionally. Perceived importance of telehealth in education was rated on a 5-point Likert scale (1 = very important to 5 = not at all important). The importance of telehealth post-COVID-19 was also measured on a 5-point Likert scale (1 = absolutely, 2 = maybe, 3 = rarely, 4 = not at all, 5 = no opinion). Experience-related questions offered options like “self-performed,” “observed,” and “neither performed nor observed.” Statistical Analysis Data were analyzed using SPSS version 16, which was used due to institutional licensing limitations and availability. Descriptive data were analyzed using frequency and percentage for categorical variables and mean ± standard deviation for continuous variables. Chi-square, t-test, and Kruskal-Wallis tests were used to analyze relationships between categorical variables. A significance level of P < 0.05 was considered. Results A total of 132 students participated in the study to assess Paramedical students’ attitudes and experiences regarding telehealth. Table 1 summarizes the demographic characteristics of students. The average age of participants was 23.04 ± 4.04 years; 72% were female and 28% male. Regarding ICT skills, 42.4% rated their competence as “good” and 20.5% as “very good.” Only 6.8% considered their ICT skills “insufficient.” The majority of students were from the Health Information Technology (HIT) (34.8%, n = 46), while Physiotherapy had the fewest (6.8%, n = 9). Table 1 Frequency distribution and demographic characteristics of students (N = 132) Characteristics Total, n (%) Age (Median) 23.04 ± 4.04 Gender Male 37 (28%) Female 95 (72%) Programs Bachelor 99 Master 31 Ph.D 2 Self-assessed ICT b competence 1 = very good 27 (20.5%) 2 = good 56 (42.4%) 3 = medium 20 (15.2%) 4 = sufficient 20 (15.2%) 5 = not sufficient 9 (6.8%) Field of study Health Information Technology 46 (34.8) Laboratory Science 20 (34.8) Optometry 14 (34.8) Radiology 11 (34.8) Speech Language Therapy 11 (34.8) Occupational Therapy 11 (34.8) Social Work 10 (7.3) Physiotherapy 9 (34.8) Differences Among Subgroups Kruskal-Walli’s test results (Table 3) indicated statistically significant differences between educational levels regarding telehealth knowledge (P = 0.014) and perceived importance of telehealth in education (P = 0.042). However, no significant differences were found based on gender or academic semester in terms of interest, Perceived Knowledge, or perceived importance of telehealth, including after the COVID-19 pandemic. Table 2 Results of the Kruskal Wallis H test for each subgroup test. Telehealth Interest Perceived Knowledge of Telehealth Telehealth Importance in Education Telehealth Relevance after Covid19 Kruskal Wallis H test ( df ) P value Kruskal Wallis H test ( df ) P value Kruskal Wallis H test ( df ) P value Kruskal Wallis H test ( df ) P value Educational level (3.9)2 .138 2(8.4) . 014 (6.3)2 . 042 (1.6)2 .441 Genders (.179)1 .672 (.259)1 .611 (.033)1 .856 (.293)1 .588 Semester (3.1)7 .870 (9.3)7 .229 (4.8)7 .674 (7.4)7 .382 Interest in Telehealth Overall, 21.2% of students (n = 28) were very interested, and 51.5% (n = 68) were somewhat interested in telehealth. Fields with the highest interest were SPT (100%, n = 11), HIT (85%, n = 39), and LS (65%, n = 13). Least interested fields were PT (50%, n = 4) and OT (45%, n = 5). Mean scores by field are shown in Fig. 1. Perceived Knowledge of Telehealth Only 3.8% (n = 5) reported extensive knowledge and professional exposure to telehealth applications. 7.6% (n = 10) knew some applications; 50% (n = 66) were familiar with telehealth in medical services but not in their profession. 24.2% (n = 32) were aware of the term but had little information, and 14.4% (n = 19) had never heard of it. Averages by field are illustrated in Fig. 1. Importance of Telehealth in Education 27.3% (n = 36) found telehealth very important in their education, while 50% (n = 66) considered it relatively important. Fields with the highest importance scores were HIT (91.3%), SPT (91%), and OT (81.9%). Only 6.8% (n = 9) found it unimportant, and 6.8% (n = 9) considered it not important at all. See Fig. 1 for field-based averages. Telehealth after -COVID-19 56.1% (n = 74) believed telehealth would be relevant to their profession post-pandemic, while 25% (n = 33) thought it might be. Most confident fields: SPT (100%), HIT (93.5%), OPT (71.5%), and LS (70%). Meanwhile, 10.6% (n = 14) believed it would not be relevant, and 0.75% (n = 1) were sure of its irrelevance. Figure 1 provides further details. Various Applications of Telehealth The various forms of telehealth services, in order of frequency from most to least, include: the use of self-management programs in healthcare (40.3% [132/53]), virtual reality/gaming or home exercise (36.4% [132/48]), telephone consultation (34.8% [132/46]), video call consultations (16.7% [132/40]), self-management information through video calls or websites (29.5% [132/39]), video call treatments (28.8% [132/38]), movement or activity monitoring using sensors (27.3% [132/36]), monitoring vital signs via sensors (23.5% [132/31]), telephone treatment (17.4% [132/23]), and 22 students had no opinion on this matter (25.3%). Details of the various applications of telehealth are shown in Fig. 2. Experience with Telehealth Overall, 28.8% (132/38) of the students had experience with telehealth. Additionally, 97.8% (132/126) of students had observed various telehealth applications during their internship or professional career. 10.6% (132/14) of the students had engaged in telephone or video consultation or treatment, and 37.9% (132/50) had observed telephone or video consultation or treatment. 10.6% (132/14) of the students had used telehealth programs for self-management, self-learning, or remote monitoring. 32.6% (132/43) had observed the use of telehealth programs for self-management, self-learning, or remote monitoring. 7.6% (132/10) of the students had engaged in remote gaming or exercise (video games) or virtual reality, and 27.3% (132/36) had observed these activities. Furthermore, in response to an open-ended question about other experiences or observations related to telehealth, students mentioned instances such as checking the living environment of patients via video calls, online dermatology consultations, and video calls through Google Meet for online treatment. Telehealth Content in the Curriculum Students’ preferences for telehealth content in their curriculum, ranked from highest to lowest, include: 1) practical training with devices, software, or applications (mean 1), 2) technical skills for using devices and software (mean 2), 3) technical knowledge of device and software principles (mean 3), 4) practical application in fieldwork (mean 2), 5) analytical skills for data interpretation (mean 2), 6) practical tips and exercises for delivering telehealth services (mean 1), 7) content on usability, user experience, and telehealth acceptance (mean 2), 8) case examples for telehealth with different target groups (mean 1), 9) scientific evidence on telehealth (mean 2), 10) data protection in telehealth (mean 2), 11) introduction to devices, software, or applications (mean 1.5), 12) content related to gamification and feedback systems (mean 2.5), 13) knowledge about movement analysis through telehealth (mean 2), 14) development of telehealth content (e.g., video exercises or educational programs; median 2), 15) legal aspects of telehealth (mean 2), and 16) knowledge about critical evaluation of telehealth programs (mean 2). Details of the academic programs are shown in Fig. 3. Based on the results, 25.8% (132/34) of students preferred to learn with peers from the same field, 9.1% (132/12) preferred to learn with students from other fields, and 56.8% (132/75) of students preferred to learn about telehealth with both groups of students from the same and other fields. 9.09% (132/12) of students had no interest in learning telehealth, and 8.3% (132/11) had no opinion on this matter. Furthermore, 23.5% (132/31) of students preferred telehealth to be taught as a mandatory course in their curriculum, 57.6% (132/76) preferred it as an elective course, 1.5% (132/2) opposed telehealth education in the curriculum, and 17.4% (132/23) had no opinion on this issue. Regarding the preferred time for teaching telehealth, in the undergraduate program, 10.5% (132/18) of students preferred the first or second semester, 60.5% (132/9) preferred the third or fourth semester, and 26.8% (132/25) preferred the fifth or sixth semester. 2.1% (132/2) of participants had no opinion. In the master’s program, 30% (132/9) of students preferred the first or second semester, and 68% (132/5) preferred the third or fourth semester. In the doctoral program, 50% (132/1) of students preferred the first or second semester, and 50% (132/1) preferred the seventh or eighth semester. Discussion The present study found that most Paramedical students have a positive attitude toward telehealth and show a high level of interest in learning and using it in their future professional careers. The highest interest was reported among students in the fields of Health Information Technology, Speech Therapy, and Laboratory Sciences, which is predictable given the technology-driven nature of these disciplines. Differences in interest based on field of study and gender were also observed. Although these differences cannot be conclusively analyzed due to the predominance of female students in the sample, they align with findings from a study in the United States, which showed that women are more inclined to adopt new healthcare technologies (25). Additionally, nearly half of the students had experience with or had observed telehealth services, although their overall awareness was relatively low. Approximately half of the students had experience with or had observed telehealth services, though their overall awareness was relatively low. These findings align with Kunjumon et al. (26), who found that the level of knowledge among paramedical students regarding telehealth was moderate. While students acknowledge the importance of telehealth, there is still a lack of deep understanding and practical training in this field. In contrast, Pitt et al.’s study with medical students reported higher levels of knowledge, which may reflect differences across disciplines (21). Byambasuren’s study further supports the effectiveness of telephone and video consultations in telehealth, which aligns with the positive experiences and attitudes reported by students in this study (27). Telehealth methods, such as phone calls, video conferencing, and secure messaging, have seen significant growth, particularly after the COVID-19 pandemic, which led to a global expansion of these technologies (28). In this study, 48.5% of students reported experience with remote consultations or treatments via phone or video, while 43.2% used telehealth apps for self-management and self-learning. These results are consistent with a study in Turkey, where most physiotherapy and rehabilitation students used telehealth services during the COVID-19 pandemic, making it an essential part of education and healthcare. This suggests that practical training and access to technological tools, especially in fields like Health Information Technology and Physiotherapy, significantly influence students’ experiences and interest in telehealth (29). Similarly, Davies et al. (2020) found that physiotherapy students feel well-prepared to use telehealth for clinical consultations, considering it a practical option for physical treatments (25). Further studies, such as those by Campbell et al. (2021), emphasize the importance of hands-on training in telehealth technologies, with many doctoral physiotherapy students expressing a desire for more training to incorporate these methods into their future practice (30). While this study primarily focused on exploring paramedical students’ attitudes and experiences toward telehealth, it also highlights the need for a more robust pedagogical framework to integrate telehealth education into academic curricula. Previous research has underscored the effectiveness of interventions involving non-specialists and digital technology in healthcare education, particularly in low- and middle-income countries, where access to resources is limited (18). This aligns with the growing emphasis on preparing students for remote patient monitoring and wearable technologies, which are increasingly integral to clinical practice (19). Moreover, studies such as Maheu et al. (31) emphasize the importance of interprofessional experiences in telehealth, especially in telebehavioral health, which requires coordinated efforts across multiple healthcare disciplines. The findings of these studies support the idea that telehealth competencies should be systematically integrated into paramedical curricula to equip students with the skills necessary for effective telehealth delivery in diverse healthcare settings. Limitations This study had several limitations that may have influenced the results. First, it was conducted at a single university, which may limit the generalizability of the findings. Second, the questionnaire mainly assessed attitudes, awareness, and perceived familiarity rather than objective knowledge or practical skills; therefore, the results do not accurately reflect the students’ competencies or actual performance. Additionally, due to curriculum constraints and limited clinical opportunities, students’ exposure to telehealth may have been restricted, impacting the responses. Furthermore, the study lacked a specific educational framework for interpreting the results and was not designed to evaluate the impact of the curriculum. These limitations highlight the need for future research using interdisciplinary approaches and established evaluation models, such as the Kirkpatrick Model and the Dreyfus Model (32, 33), to better assess skill development and the effectiveness of educational interventions in telehealth. Conclusion While telehealth is recognized as an important tool for healthcare delivery in the future, there is a need for greater focus on practical education and the provision of appropriate tools in this field. The results of this study and others indicate that Paramedical students and other healthcare-related groups are eager to adopt these technologies but require more education and preparation to use them effectively. The findings of this study can serve as an initial step in identifying the educational needs of students in telehealth and help create a foundation for developing skill-based and educational interventions. Therefore, it is recommended that universities and educational institutions incorporate telehealth training into their curricula through practical and applied courses, ensuring that students are adequately prepared for the effective use of these methods in their future careers. Abbreviations WHO World Health Organization ICT Information and Communications Technology AAMC Association of American Medical Colleges HIT Health Information Technology LS Laboratory Science OPT Optometry RL Radiology SLT Speech Language Terapy OT Occupational Terapy SW Social Work PT Physioterapy Declarations Ethics approval and consent to participate Ethics This study is derived from a research project approved by Mashhad University of Medical Sciences (Ethics Code: IR.MUMS.FHMPM.REC.1403.136). All ethical principles in the research were observed according to the Hellenic Declaration. Students entered the research with informed consent after the research was explained. All information from individuals was used confidentially and without revealing their names.approval and consent to participate Consent for publication Not applicable Data Availablity The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. Competing Interests The authors declare that there is no conflict of interest in this research. Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Authors' contributions RNA : Contributed to Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Resources, Software, Validation, Visualization, writing – original draft, KhK : Project administration, Supervision, Validation, Visualization, writing – original draft, writing – review and editing, MS , and SFM : Data curation, Resources. All authors read and approved the final manuscript. Acknowledgements The authors stated that all information provided in this article could be shared. All authors have read and approved the final version of the manuscript. Khalil Kimiafar had full access to all of the data in this study and took complete responsibility for the integrity of the data and the accuracy of the data analysis. We also thank all students for their participation and cooperation in this project. ORCID IDs Reyhane Norouzi Aval http://orcid.org/0000-0002-0863-0940 Khalil Kimiafar http://orcid.org/0000-0003-0351-4675 Masoumeh Sarbaz http://orcid.org/0000-0001-5456-8505 Seyyedeh Fatemeh Mousavi Baigi http://orcid.org/0000- 0002- 2214-0077 References Tuckson RV, Edmunds M, Hodgkins ML. Telehealth. New England Journal of Medicine. 2017;377(16):1585-92. Association AOT. AOTA 2021 standards for continuing competence in occupational therapy. The American Journal of Occupational Therapy. 2021;75(Supplement_3):7513410040. 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Cite Share Download PDF Status: Published Journal Publication published 22 Jul, 2025 Read the published version in BMC Medical Education → Version 1 posted Editorial decision: Revision requested 16 Jun, 2025 Reviews received at journal 10 Jun, 2025 Reviewers agreed at journal 10 Jun, 2025 Reviews received at journal 10 Jun, 2025 Reviewers agreed at journal 25 Apr, 2025 Reviews received at journal 17 Apr, 2025 Reviewers agreed at journal 17 Apr, 2025 Reviewers invited by journal 17 Apr, 2025 Submission checks completed at journal 16 Apr, 2025 First submitted to journal 10 Apr, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5974342","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":444619163,"identity":"3c84d37b-a22a-4fe3-87b8-5e4b92cbd0c3","order_by":0,"name":"Reyhaneh Norouzi Aval","email":"","orcid":"","institution":"Mashhad University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Reyhaneh","middleName":"Norouzi","lastName":"Aval","suffix":""},{"id":444619164,"identity":"0fc5d274-f99f-4074-aa43-42e2ce87a860","order_by":1,"name":"Khalil Kimiafar","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA50lEQVRIiWNgGAWjYBACCWYGhgMMNkCGBPMBuOgBnOrhWtJAWtgSiNQCJsFaeAyIc5hkO3figR8JdvmSs3u+bubNqWPgbz/AeLgCjxZpZt4NB3sSki1ny5zddpt322EGiTMJDAfP4NEiB9RygPcHs4GcRC5IC9AXNxgYDjYQ0HLwT0I9UEvOM6CWOgZ5QlpADjvMk3DYQFoihw2ohZnBgJAWyWagFpmE4waSM9LMbs7ddpjH8ExiA14tEufPbv74JqHaQOJG8rMbb7fVyckdP3z4Iz4tGICHgYGRJA2jYBSMglEwCrAAAGFBTtRyjNlbAAAAAElFTkSuQmCC","orcid":"","institution":"Mashhad University of Medical Sciences","correspondingAuthor":true,"prefix":"","firstName":"Khalil","middleName":"","lastName":"Kimiafar","suffix":""},{"id":444619165,"identity":"e7675afb-9ea7-41cc-b05b-8ec913949f66","order_by":2,"name":"Masoumeh Sarbaz","email":"","orcid":"","institution":"Mashhad University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Masoumeh","middleName":"","lastName":"Sarbaz","suffix":""},{"id":444619166,"identity":"e1664316-ab36-4f22-8ee9-ef97f46e3636","order_by":3,"name":"Seyyedeh Fatemeh Mousavi Baigi","email":"","orcid":"","institution":"Mashhad University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Seyyedeh","middleName":"Fatemeh Mousavi","lastName":"Baigi","suffix":""}],"badges":[],"createdAt":"2025-02-06 14:23:23","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5974342/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5974342/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12909-025-07712-8","type":"published","date":"2025-07-22T15:57:59+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":80894209,"identity":"4d0e568d-1622-4182-9af1-e8e2ab5cb634","added_by":"auto","created_at":"2025-04-18 11:15:30","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":82007,"visible":true,"origin":"","legend":"\u003cp\u003eHeatmap of Telehealth Interest, Perceived Knowledge of Telehealth, Telehealth Importance in Education, and Telehealth after Covid19 for each field of study. HIT: Health Information Technology, OPT: Optometry, RL: Radiology, LS: Laboratory Science, OT: Occupational Therapy, SW: Social Work, PT: Physiotherapy, SLT: Speech Language Therapy\u003c/p\u003e","description":"","filename":"Fig1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-5974342/v1/0e4ca61ac4d0eed5a8479ddc.jpg"},{"id":80894208,"identity":"b58d028b-538b-4ef2-a70e-7ba2077f6d9b","added_by":"auto","created_at":"2025-04-18 11:15:30","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":97866,"visible":true,"origin":"","legend":"\u003cp\u003eStudents' Perception of the Relevance of Various Applications\u003cstrong\u003e \u003c/strong\u003eof Telehealth in Relation to Their Professions\u003c/p\u003e","description":"","filename":"Fig2.png","url":"https://assets-eu.researchsquare.com/files/rs-5974342/v1/14f0b0ce55c6a6c53f747d43.png"},{"id":80894751,"identity":"7537dcc7-e0cd-4c70-8467-9eb4ba4df950","added_by":"auto","created_at":"2025-04-18 11:23:30","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":180673,"visible":true,"origin":"","legend":"\u003cp\u003eStudents’ preferences for telehealth content in the curriculum\u003c/p\u003e","description":"","filename":"Fig3.jpg","url":"https://assets-eu.researchsquare.com/files/rs-5974342/v1/57b8f3f88b0764b34d90960c.jpg"},{"id":87757402,"identity":"5b51782a-5426-46f8-ae83-ea4a30989052","added_by":"auto","created_at":"2025-07-28 16:10:48","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1093994,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5974342/v1/05161d71-0ed2-4929-8335-31682ca0e909.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Attitudes and Experience of Paramedical Students Toward Telehealth in Education, A Cross-Sectional Study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eTelehealth is defined as the delivery and facilitation of health and health-related services\u0026mdash;including medical care, provider and patient education, health information services, and self-care\u0026mdash;via telecommunications and digital communication technologies, using innovative methods such as online consultations, remote monitoring, and the provision of healthcare services (1). With remarkable advancements in technology, telehealth has become an integral component of modern healthcare, playing a significant role in improving the quality of medical services and facilitating access to healthcare (2\u0026ndash;4). According to recent estimates, over 60% of healthcare institutions in the United States and nearly half of the hospitals utilize telehealth, underscoring its importance in increasing access to care, reducing costs, and enhancing patient experience globally (1). The World Health Organization (WHO) has also emphasized the importance of using information and communication technologies (ICT) in healthcare programs (5). Telehealth is particularly recognized for its ability to reduce geographic barriers and improve access to healthcare for underserved populations, such as those in rural and disadvantaged areas (6\u0026ndash;8).\u003c/p\u003e \u003cp\u003eThe growing use of this technology highlights the need for telehealth education for healthcare providers (9). To successfully implement telehealth and leverage its benefits, integrating telehealth into the curricula of future healthcare professionals is essential (10). Notably, telehealth education for medical and nursing students began in the late 1990s, and many academic institutions have recently paid increased attention to this technology (11). However, one of the major challenges in telehealth adoption is the need for proper education in this area (12). A recent survey by the Association of American Medical Colleges (AAMC) revealed that currently only 58% of medical schools offer telehealth training (13, 14). This educational gap became more pronounced during the COVID-19 pandemic, when the need for telehealth became increasingly evident (15).\u003c/p\u003e \u003cp\u003eMoreover, research indicates that a lack of knowledge and experience in telehealth is one of the main barriers to its adoption among students and healthcare providers (9). However, telehealth education can enhance confidence, preparedness, and acceptance of this technology (10, 16, 17). Despite its significance, formal telehealth education is still insufficiently incorporated into many academic programs (18, 19). Numerous studies have examined the educational needs and existing challenges in delivering effective telehealth training, including those highlighting the importance of leveraging modern technologies to improve healthcare quality and enhance students\u0026rsquo; capabilities in utilizing such technologies (19).\u003c/p\u003e \u003cp\u003eAdditionally, recent studies, including those by Boos and Sabrina, have shown that experience-based educational modules can significantly improve students\u0026rsquo; knowledge, attitudes, and confidence in using telehealth (20, 21). Two systematic reviews conducted in 2021 identified major deficiencies in the integration of telehealth into health and nursing curricula, such as lack of coherence, absence of clear standards, and a mismatch between educational content and actual clinical needs (22, 23).\u003c/p\u003e \u003cp\u003eTherefore, a significant gap in the current literature is the lack of structured programs for telehealth education in Paramedical disciplines. Despite recent efforts to incorporate telehealth into education, most studies have focused on medical and nursing students, and there is limited information on the status of telehealth education and attitudes among Paramedical students. Accordingly, the aim of the present study is to explore the attitudes, experiences, and perceptions of Paramedical students at Mashhad University of Medical Sciences regarding telehealth. It is also worth noting that many studies, including the present one, assess students\u0026rsquo; perceptions and understandings of the subject rather than actual competencies, which may not necessarily correlate directly with behavioral performance.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Design\u003c/h2\u003e \u003cp\u003eThis cross-sectional quantitative study was conducted from October 2024 to February 2025. All ethical principles outlined in the Declaration of Helsinki were strictly adhered to (24). Accordingly, students were clearly informed about the objectives, procedures, potential benefits and risks, and possible discomforts related to the study. Participation was voluntary, and informed consent was obtained from all participants. As an incentive for participation, the objectives of the study were explained at the beginning of the questionnaire, and participants were informed that they would receive a general feedback on the results upon completion of the study. All personal information was kept confidential and anonymized for research purposes only.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eSample Size\u003c/h3\u003e\n\u003cp\u003eThe study population included all students enrolled in the School of Paramedical Sciences and Rehabilitation at Mashhad University of Medical Sciences during the 2024 academic year. These students were from eight disciplines: Health Information Technology, Laboratory Sciences, Optometry, Radiology, Speech Therapy, Occupational Therapy, Physiotherapy, and Social Work, and were studying at undergraduate, master\u0026rsquo;s, and doctoral levels. Stratified proportional sampling was employed: students were first categorized by discipline and academic level, and then a proportionate sample was selected from each stratum based on Cochran\u0026rsquo;s formula (with a confidence level of 95% and α\u0026thinsp;=\u0026thinsp;0.05). The initial sample size was 87; however, to enhance accuracy and generalizability, a total of 132 participants were ultimately included.\u003c/p\u003e \u003cp\u003e\u003cimg 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\"\u003e\u003c/p\u003e\u003cp\u003en\u0026thinsp;=\u0026thinsp;Number of samples required to carry out the design\u003c/p\u003e \u003cp\u003eZ\u0026thinsp;=\u0026thinsp;The value of the statistic equivalent to the area under the standard normal curve\u003c/p\u003e \u003cp\u003eP and q\u0026thinsp;=\u0026thinsp;The frequency ratio of the desired trait in the target population\u003c/p\u003e \u003cp\u003ed\u0026thinsp;=\u0026thinsp;Effect size or precision\u003c/p\u003e \u003cp\u003eInclusion criteria were all students actively enrolled at the School of Paramedical Sciences and Rehabilitation at the time of the study. Exclusion criteria included transfer or visiting students from other universities, students on academic leave during data collection, international students, and those unwilling to participate.\u003c/p\u003e \u003cp\u003e Participation was entirely voluntary and based on informed consent. Participants were assured that their information would remain confidential and be used solely for research purposes.\u003c/p\u003e\n\u003ch3\u003eData Collection\u003c/h3\u003e\n\u003cp\u003eTo evaluate students\u0026rsquo; attitudes and experiences, a pre-developed standardized questionnaire by Retinger et al. was used (9). The face validity of the questionnaire was reviewed by five faculty members, and after incorporating their suggestions, the final version was approved. Its reliability was assessed using the test-retest method with a 10-day interval (Cronbach\u0026rsquo;s alpha: 78%). The questionnaire included 18 questions covering demographic data (age, gender, educational level, field of study), respondents\u0026rsquo; ICT competence, interest in telehealth, perceived telehealth knowledge, importance of telehealth, various applications of telehealth, telehealth experiences, telehealth in education, and three open-ended questions exploring students\u0026rsquo; perspectives on telehealth. The questionnaire was designed electronically, and an email with the survey link was sent to eligible students willing to participate. Two reminder emails were sent at one-week intervals. Participation was voluntary, and responses were anonymous.\u003c/p\u003e \u003cp\u003eInterest in telehealth was rated on a 5-point Likert scale (1\u0026thinsp;=\u0026thinsp;not interested, 2\u0026thinsp;=\u0026thinsp;slightly interested, 3\u0026thinsp;=\u0026thinsp;somewhat interested, 4\u0026thinsp;=\u0026thinsp;very interested, 5\u0026thinsp;=\u0026thinsp;no opinion). Perceived knowledge of telehealth was assessed by choosing one of five statements ranging from never having heard of telehealth to knowing many of its applications professionally. Perceived importance of telehealth in education was rated on a 5-point Likert scale (1\u0026thinsp;=\u0026thinsp;very important to 5\u0026thinsp;=\u0026thinsp;not at all important). The importance of telehealth post-COVID-19 was also measured on a 5-point Likert scale (1\u0026thinsp;=\u0026thinsp;absolutely, 2\u0026thinsp;=\u0026thinsp;maybe, 3\u0026thinsp;=\u0026thinsp;rarely, 4\u0026thinsp;=\u0026thinsp;not at all, 5\u0026thinsp;=\u0026thinsp;no opinion). Experience-related questions offered options like \u0026ldquo;self-performed,\u0026rdquo; \u0026ldquo;observed,\u0026rdquo; and \u0026ldquo;neither performed nor observed.\u0026rdquo;\u003c/p\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eStatistical Analysis\u003c/h2\u003e \u003cp\u003eData were analyzed using SPSS version 16, which was used due to institutional licensing limitations and availability. Descriptive data were analyzed using frequency and percentage for categorical variables and mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation for continuous variables. Chi-square, t-test, and Kruskal-Wallis tests were used to analyze relationships between categorical variables. A significance level of P\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 132 students participated in the study to assess Paramedical students\u0026rsquo; attitudes and experiences regarding telehealth. Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e summarizes the demographic characteristics of students. The average age of participants was 23.04\u0026thinsp;\u0026plusmn;\u0026thinsp;4.04 years; 72% were female and 28% male. Regarding ICT skills, 42.4% rated their competence as \u0026ldquo;good\u0026rdquo; and 20.5% as \u0026ldquo;very good.\u0026rdquo; Only 6.8% considered their ICT skills \u0026ldquo;insufficient.\u0026rdquo; The majority of students were from the Health Information Technology (HIT) (34.8%, n\u0026thinsp;=\u0026thinsp;46), while Physiotherapy had the fewest (6.8%, n\u0026thinsp;=\u0026thinsp;9).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFrequency distribution and demographic characteristics of students (N\u0026thinsp;=\u0026thinsp;132)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal, n (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (Median)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23.04\u0026thinsp;\u0026plusmn;\u0026thinsp;4.04\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e37 (28%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e95 (72%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePrograms\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBachelor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e99\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMaster\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePh.D\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSelf-assessed ICT\u003c/b\u003e \u003csup\u003e\u003cb\u003eb\u003c/b\u003e\u003c/sup\u003e \u003cb\u003ecompetence\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u0026thinsp;=\u0026thinsp;very good\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27 (20.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2\u0026thinsp;=\u0026thinsp;good\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e56 (42.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3\u0026thinsp;=\u0026thinsp;medium\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20 (15.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4\u0026thinsp;=\u0026thinsp;sufficient\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20 (15.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5\u0026thinsp;=\u0026thinsp;not sufficient\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9 (6.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eField of study\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHealth Information Technology\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e46 (34.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLaboratory Science\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20 (34.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOptometry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14 (34.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRadiology\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11 (34.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSpeech Language Therapy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11 (34.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOccupational Therapy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11 (34.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSocial Work\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10 (7.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePhysiotherapy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9 (34.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eDifferences Among Subgroups\u003c/h2\u003e \u003cp\u003eKruskal-Walli\u0026rsquo;s test results (Table\u0026nbsp;3) indicated statistically significant differences between educational levels regarding telehealth knowledge (P\u0026thinsp;=\u0026thinsp;0.014) and perceived importance of telehealth in education (P\u0026thinsp;=\u0026thinsp;0.042). However, no significant differences were found based on gender or academic semester in terms of interest, Perceived Knowledge, or perceived importance of telehealth, including after the COVID-19 pandemic.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eResults of the Kruskal Wallis H test for each subgroup test.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"9\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTelehealth Interest\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePerceived Knowledge of Telehealth\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eTelehealth Importance in\u003c/p\u003e \u003cp\u003eEducation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eTelehealth Relevance after Covid19\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKruskal Wallis H test (\u003cem\u003edf\u003c/em\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eKruskal Wallis H test (\u003cem\u003edf\u003c/em\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eKruskal Wallis H test (\u003cem\u003edf\u003c/em\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eKruskal Wallis H test (\u003cem\u003edf\u003c/em\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEducational level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e(3.9)2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.138\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2(8.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.\u003cb\u003e014\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(6.3)2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.\u003cb\u003e042\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e(1.6)2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.441\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGenders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e(.179)1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.672\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e(.259)1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.611\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(.033)1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.856\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e(.293)1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.588\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSemester\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e(3.1)7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.870\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e(9.3)7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.229\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(4.8)7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.674\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e(7.4)7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.382\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eInterest in Telehealth\u003c/h3\u003e\n\u003cp\u003eOverall, 21.2% of students (n\u0026thinsp;=\u0026thinsp;28) were very interested, and 51.5% (n\u0026thinsp;=\u0026thinsp;68) were somewhat interested in telehealth. Fields with the highest interest were SPT (100%, n\u0026thinsp;=\u0026thinsp;11), HIT (85%, n\u0026thinsp;=\u0026thinsp;39), and LS (65%, n\u0026thinsp;=\u0026thinsp;13). Least interested fields were PT (50%, n\u0026thinsp;=\u0026thinsp;4) and OT (45%, n\u0026thinsp;=\u0026thinsp;5). Mean scores by field are shown in Fig.\u0026nbsp;1.\u003c/p\u003e\n\u003ch3\u003ePerceived Knowledge of Telehealth\u003c/h3\u003e\n\u003cp\u003eOnly 3.8% (n\u0026thinsp;=\u0026thinsp;5) reported extensive knowledge and professional exposure to telehealth applications. 7.6% (n\u0026thinsp;=\u0026thinsp;10) knew some applications; 50% (n\u0026thinsp;=\u0026thinsp;66) were familiar with telehealth in medical services but not in their profession. 24.2% (n\u0026thinsp;=\u0026thinsp;32) were aware of the term but had little information, and 14.4% (n\u0026thinsp;=\u0026thinsp;19) had never heard of it. Averages by field are illustrated in Fig.\u0026nbsp;1.\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eImportance of Telehealth in Education\u003c/h2\u003e \u003cp\u003e27.3% (n\u0026thinsp;=\u0026thinsp;36) found telehealth very important in their education, while 50% (n\u0026thinsp;=\u0026thinsp;66) considered it relatively important. Fields with the highest importance scores were HIT (91.3%), SPT (91%), and OT (81.9%). Only 6.8% (n\u0026thinsp;=\u0026thinsp;9) found it unimportant, and 6.8% (n\u0026thinsp;=\u0026thinsp;9) considered it not important at all. See Fig.\u0026nbsp;1 for field-based averages.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eTelehealth after -COVID-19\u003c/h2\u003e \u003cp\u003e56.1% (n\u0026thinsp;=\u0026thinsp;74) believed telehealth would be relevant to their profession post-pandemic, while 25% (n\u0026thinsp;=\u0026thinsp;33) thought it might be. Most confident fields: SPT (100%), HIT (93.5%), OPT (71.5%), and LS (70%). Meanwhile, 10.6% (n\u0026thinsp;=\u0026thinsp;14) believed it would not be relevant, and 0.75% (n\u0026thinsp;=\u0026thinsp;1) were sure of its irrelevance. Figure\u0026nbsp;1 provides further details.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eVarious Applications of Telehealth\u003c/h2\u003e \u003cp\u003eThe various forms of telehealth services, in order of frequency from most to least, include: the use of self-management programs in healthcare (40.3% [132/53]), virtual reality/gaming or home exercise (36.4% [132/48]), telephone consultation (34.8% [132/46]), video call consultations (16.7% [132/40]), self-management information through video calls or websites (29.5% [132/39]), video call treatments (28.8% [132/38]), movement or activity monitoring using sensors (27.3% [132/36]), monitoring vital signs via sensors (23.5% [132/31]), telephone treatment (17.4% [132/23]), and 22 students had no opinion on this matter (25.3%). Details of the various applications of telehealth are shown in Fig.\u0026nbsp;2.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eExperience with Telehealth\u003c/h2\u003e \u003cp\u003eOverall, 28.8% (132/38) of the students had experience with telehealth. Additionally, 97.8% (132/126) of students had observed various telehealth applications during their internship or professional career. 10.6% (132/14) of the students had engaged in telephone or video consultation or treatment, and 37.9% (132/50) had observed telephone or video consultation or treatment.\u003c/p\u003e \u003cp\u003e10.6% (132/14) of the students had used telehealth programs for self-management, self-learning, or remote monitoring. 32.6% (132/43) had observed the use of telehealth programs for self-management, self-learning, or remote monitoring. 7.6% (132/10) of the students had engaged in remote gaming or exercise (video games) or virtual reality, and 27.3% (132/36) had observed these activities. Furthermore, in response to an open-ended question about other experiences or observations related to telehealth, students mentioned instances such as checking the living environment of patients via video calls, online dermatology consultations, and video calls through Google Meet for online treatment.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eTelehealth Content in the Curriculum\u003c/h2\u003e \u003cp\u003eStudents\u0026rsquo; preferences for telehealth content in their curriculum, ranked from highest to lowest, include: 1) practical training with devices, software, or applications (mean 1), 2) technical skills for using devices and software (mean 2), 3) technical knowledge of device and software principles (mean 3), 4) practical application in fieldwork (mean 2), 5) analytical skills for data interpretation (mean 2), 6) practical tips and exercises for delivering telehealth services (mean 1), 7) content on usability, user experience, and telehealth acceptance (mean 2), 8) case examples for telehealth with different target groups (mean 1), 9) scientific evidence on telehealth (mean 2), 10) data protection in telehealth (mean 2), 11) introduction to devices, software, or applications (mean 1.5), 12) content related to gamification and feedback systems (mean 2.5), 13) knowledge about movement analysis through telehealth (mean 2), 14) development of telehealth content (e.g., video exercises or educational programs; median 2), 15) legal aspects of telehealth (mean 2), and 16) knowledge about critical evaluation of telehealth programs (mean 2). Details of the academic programs are shown in Fig.\u0026nbsp;3.\u003c/p\u003e\u003cp\u003eBased on the results, 25.8% (132/34) of students preferred to learn with peers from the same field, 9.1% (132/12) preferred to learn with students from other fields, and 56.8% (132/75) of students preferred to learn about telehealth with both groups of students from the same and other fields. 9.09% (132/12) of students had no interest in learning telehealth, and 8.3% (132/11) had no opinion on this matter. Furthermore, 23.5% (132/31) of students preferred telehealth to be taught as a mandatory course in their curriculum, 57.6% (132/76) preferred it as an elective course, 1.5% (132/2) opposed telehealth education in the curriculum, and 17.4% (132/23) had no opinion on this issue. Regarding the preferred time for teaching telehealth, in the undergraduate program, 10.5% (132/18) of students preferred the first or second semester, 60.5% (132/9) preferred the third or fourth semester, and 26.8% (132/25) preferred the fifth or sixth semester. 2.1% (132/2) of participants had no opinion. In the master\u0026rsquo;s program, 30% (132/9) of students preferred the first or second semester, and 68% (132/5) preferred the third or fourth semester. In the doctoral program, 50% (132/1) of students preferred the first or second semester, and 50% (132/1) preferred the seventh or eighth semester.\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe present study found that most Paramedical students have a positive attitude toward telehealth and show a high level of interest in learning and using it in their future professional careers. The highest interest was reported among students in the fields of Health Information Technology, Speech Therapy, and Laboratory Sciences, which is predictable given the technology-driven nature of these disciplines. Differences in interest based on field of study and gender were also observed. Although these differences cannot be conclusively analyzed due to the predominance of female students in the sample, they align with findings from a study in the United States, which showed that women are more inclined to adopt new healthcare technologies (25). Additionally, nearly half of the students had experience with or had observed telehealth services, although their overall awareness was relatively low.\u003c/p\u003e \u003cp\u003eApproximately half of the students had experience with or had observed telehealth services, though their overall awareness was relatively low. These findings align with Kunjumon et al. (26), who found that the level of knowledge among paramedical students regarding telehealth was moderate. While students acknowledge the importance of telehealth, there is still a lack of deep understanding and practical training in this field. In contrast, Pitt et al.\u0026rsquo;s study with medical students reported higher levels of knowledge, which may reflect differences across disciplines (21). Byambasuren\u0026rsquo;s study further supports the effectiveness of telephone and video consultations in telehealth, which aligns with the positive experiences and attitudes reported by students in this study (27).\u003c/p\u003e \u003cp\u003eTelehealth methods, such as phone calls, video conferencing, and secure messaging, have seen significant growth, particularly after the COVID-19 pandemic, which led to a global expansion of these technologies (28). In this study, 48.5% of students reported experience with remote consultations or treatments via phone or video, while 43.2% used telehealth apps for self-management and self-learning. These results are consistent with a study in Turkey, where most physiotherapy and rehabilitation students used telehealth services during the COVID-19 pandemic, making it an essential part of education and healthcare. This suggests that practical training and access to technological tools, especially in fields like Health Information Technology and Physiotherapy, significantly influence students\u0026rsquo; experiences and interest in telehealth (29). Similarly, Davies et al. (2020) found that physiotherapy students feel well-prepared to use telehealth for clinical consultations, considering it a practical option for physical treatments (25). Further studies, such as those by Campbell et al. (2021), emphasize the importance of hands-on training in telehealth technologies, with many doctoral physiotherapy students expressing a desire for more training to incorporate these methods into their future practice (30).\u003c/p\u003e \u003cp\u003eWhile this study primarily focused on exploring paramedical students\u0026rsquo; attitudes and experiences toward telehealth, it also highlights the need for a more robust pedagogical framework to integrate telehealth education into academic curricula. Previous research has underscored the effectiveness of interventions involving non-specialists and digital technology in healthcare education, particularly in low- and middle-income countries, where access to resources is limited (18). This aligns with the growing emphasis on preparing students for remote patient monitoring and wearable technologies, which are increasingly integral to clinical practice (19). Moreover, studies such as Maheu et al. (31) emphasize the importance of interprofessional experiences in telehealth, especially in telebehavioral health, which requires coordinated efforts across multiple healthcare disciplines. The findings of these studies support the idea that telehealth competencies should be systematically integrated into paramedical curricula to equip students with the skills necessary for effective telehealth delivery in diverse healthcare settings.\u003c/p\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eLimitations\u003c/h2\u003e \u003cp\u003eThis study had several limitations that may have influenced the results. First, it was conducted at a single university, which may limit the generalizability of the findings. Second, the questionnaire mainly assessed attitudes, awareness, and perceived familiarity rather than objective knowledge or practical skills; therefore, the results do not accurately reflect the students\u0026rsquo; competencies or actual performance. Additionally, due to curriculum constraints and limited clinical opportunities, students\u0026rsquo; exposure to telehealth may have been restricted, impacting the responses. Furthermore, the study lacked a specific educational framework for interpreting the results and was not designed to evaluate the impact of the curriculum. These limitations highlight the need for future research using interdisciplinary approaches and established evaluation models, such as the Kirkpatrick Model and the Dreyfus Model (32, 33), to better assess skill development and the effectiveness of educational interventions in telehealth.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eWhile telehealth is recognized as an important tool for healthcare delivery in the future, there is a need for greater focus on practical education and the provision of appropriate tools in this field. The results of this study and others indicate that Paramedical students and other healthcare-related groups are eager to adopt these technologies but require more education and preparation to use them effectively. The findings of this study can serve as an initial step in identifying the educational needs of students in telehealth and help create a foundation for developing skill-based and educational interventions. Therefore, it is recommended that universities and educational institutions incorporate telehealth training into their curricula through practical and applied courses, ensuring that students are adequately prepared for the effective use of these methods in their future careers.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eWHO\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eWorld Health Organization\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eICT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eInformation and Communications Technology\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eAAMC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAssociation of American Medical Colleges\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHIT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eHealth Information Technology\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eLS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eLaboratory Science\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eOPT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eOptometry\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eRL\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eRadiology\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSLT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eSpeech Language Terapy\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eOT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eOccupational Terapy\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSW\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eSocial Work\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePhysioterapy\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthics This study is derived from a research project approved by Mashhad University of Medical Sciences (Ethics Code: IR.MUMS.FHMPM.REC.1403.136). All ethical principles in the research were observed according to the Hellenic Declaration. Students entered the research with informed consent after the research was explained. All information from individuals was used confidentially and without revealing their names.approval and consent to participate\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availablity\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that there is no conflict of interest in this research.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRNA\u003c/strong\u003e: Contributed to Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Resources, Software, Validation, Visualization, writing \u0026ndash; original draft, \u003cstrong\u003eKhK\u003c/strong\u003e: Project administration, Supervision, Validation, Visualization, writing \u0026ndash; original draft, writing \u0026ndash; review and editing, \u0026nbsp;\u003cstrong\u003eMS\u003c/strong\u003e, and \u003cstrong\u003eSFM\u003c/strong\u003e: Data curation, Resources. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors stated that all information provided in this article could be shared. All authors have read and approved the final version of the manuscript. Khalil Kimiafar had full access to all of the data in this study and took complete responsibility for the integrity of the data and the accuracy of the data analysis. We also thank all students for their participation and cooperation in this project.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eORCID IDs\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eReyhane Norouzi Aval\u003cspan dir=\"RTL\"\u003e\u0026nbsp;\u003c/span\u003ehttp://orcid.org/0000-0002-0863-0940\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eKhalil Kimiafar\u0026nbsp;http://orcid.org/0000-0003-0351-4675\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMasoumeh Sarbaz\u0026nbsp;http://orcid.org/0000-0001-5456-8505\u003c/p\u003e\n\u003cp\u003eSeyyedeh Fatemeh Mousavi Baigi http://orcid.org/0000- 0002- 2214-0077\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eTuckson RV, Edmunds M, Hodgkins ML. Telehealth. New England Journal of Medicine. 2017;377(16):1585-92.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAssociation AOT. AOTA 2021 standards for continuing competence in occupational therapy. The American Journal of Occupational Therapy. 2021;75(Supplement_3):7513410040.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNorouzi Aval R, Rafatpanah H, Sarbaz M, Mousavi Baigi SF, Kimiafar K. Identification and Classification Features of Patient Portal, A Systematic Review. Health Sci Rep. 2025;8(3):e70520.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAval RN, Baigi SFM, Sarbaz M, Kimiafar K. Security, privacy, and confidentiality in electronic prescribing systems: A review study. Frontiers in Health Informatics. 2022;11(1):115.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKabir H, Hasan MK, Jamil S, Chowdhury SR, Mitra DK. Knowledge, perceived benefits, perceived concerns, and predisposition to use telehealth services in Bangladesh: a cross-sectional survey. BMC Digital Health. 2024;2(1):61.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKrahe MA, Conway M, Howells S, Roffey K, Reilly S. Rapid transition of an allied health clinic to telehealth during the COVID-19 pandemic: satisfaction and experience of health professionals, student practitioners, and patients. Internet Journal of Allied Health Sciences and Practice. 2021;19(3):9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNorouzi Aval R, Kimiafar K, Sarbaz M, Mousavi Baigi SF, Vakili Arki H. Effects of using patient portals in patient education: A systematic review. Journal of Health Administration. 2024;26(4):8\u0026ndash;29.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNorouzi Aval R, Kimiafar K, Sarbaz M, Mousavi Baigi SF. Examining the Attitude, Knowledge, and Awareness of Professionals Towards Telerehabilitation, A Systematic Review. Health Education and Health Promotion. 2024;12(4):1001-37.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRettinger L, Putz P, Aichinger L, Javorszky SM, Widhalm K, Ertelt-Bach V, et al. Telehealth Education in Allied Health Care and Nursing: Web-Based Cross-Sectional Survey of Students\u0026rsquo; Perceived Knowledge, Skills, Attitudes, and Experience. JMIR Medical Education. 2024;10(1):e51112.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRutledge CM, Kott K, Schweickert PA, Poston R, Fowler C, Haney TS. Telehealth and eHealth in nurse practitioner training: current perspectives. Advances in medical education and practice. 2017:399\u0026ndash;409.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlpay L, Heathfield H. A review of telematics in healthcare: evolution, challenges and caveats. Health Informatics Journal. 1997;3(2):81\u0026ndash;92.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePathipati AS, Azad TD, Jethwani K. Telemedical education: training digital natives in telemedicine. Journal of medical Internet research. 2016;18(7):e193.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKelly J. AMA encourages telemedicine training for medical students, residents. American Medical Association. 2016.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWarshaw R. From bedside to webside: future doctors learn how to practice remotely. AAMC News [Internet]. 2018.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGoldenberg MN, Hersh DC, Wilkins KM, Schwartz ML. Suspending medical student clerkships due to COVID-19. Medical science educator. 2020;30:1273-6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNewcomb AB, Duval M, Bachman SL, Mohess D, Dort J, Kapadia MR. Building rapport and earning the surgical patient's trust in the era of social distancing: teaching patient-centered communication during video conference encounters to medical students. Journal of surgical education. 2021;78(1):336\u0026thinsp;\u0026minus;\u0026thinsp;41.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGunner CK, Eisner E, Watson AJ, Duncan JL. Teaching webside manner: development and initial evaluation of a video consultation skills training module for undergraduate medical students. Medical Education Online. 1954492:(1)26;2021.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMudiyanselage KWW, De Santis KK, J\u0026ouml;rg F, Saleem M, Stewart R, Zeeb H, et al. The effectiveness of mental health interventions involving non-specialists and digital technology in low-and middle-income countries\u0026ndash;a systematic review. BMC public health. 2024;24(1):77.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHilty DM, Armstrong CM, Edwards-Stewart A, Gentry MT, Luxton DD, Krupinski EA. Sensor, wearable, and remote patient monitoring competencies for clinical care and training: scoping review. Journal of technology in behavioral science. 2021;6(2):252\u0026thinsp;\u0026minus;\u0026thinsp;77.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBoos K, Murphy K, George TS, Brandes J, Hopp J. The impact of a didactic and experiential learning model on health profession students\u0026rsquo; knowledge, perceptions, and confidence in the use of telehealth. Journal of Education and Health Promotion. 2022;11(1):232.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePit SW, Velovski S, Cockrell K, Bailey J. A qualitative exploration of medical students\u0026rsquo; placement experiences with telehealth during COVID-19 and recommendations to prepare our future medical workforce. BMC Medical Education. 2021;21:1\u0026ndash;13.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHui KY, Haines C, Bammann S, Hallandal M, Langone N, Williams C, et al. To what extent is telehealth reported to be incorporated into undergraduate and postgraduate allied health curricula: A scoping review. Plos one:8(16)2021. e0256425\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChike-Harris KE, Durham C, Logan A, Smith G, DuBose-Morris R. Integration of telehealth education into the health care provider curriculum: a review. Telemedicine and e-Health. 2021;27(2):137\u0026thinsp;\u0026minus;\u0026thinsp;49.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGoodyear MD, Krleza-Jeric K, Lemmens T. The declaration of Helsinki. British Medical Journal Publishing Group; 2007. p. 624-5.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDavies L, Lawford BJ, Chan C. Physiotherapy students' attitudes toward the use of telehealth in clinical practice: A cross-sectional survey. Health Science Reports. 2024;7(4):e2067.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKunjumon C, Shibu N, Sneha M, Joshi P, Pagi T. Knowledge regarding telehealth among paramedical students. Int J Creat Res Thoughts (IJCRT). 2021;9(1):1720-4.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eByambasuren O, Greenwood H, Bakhit M, Atkins T, Clark J, Scott AM, et al. Comparison of telephone and video telehealth consultations: systematic review. Journal of Medical Internet Research. 2023;25:e49942.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMuntz MD, Franco J, Ferguson CC, Ark TK, Kalet A. Telehealth and medical student education in the time of COVID-19\u0026mdash;and beyond. Academic Medicine. 2021;96(12):1655-9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSavkın R, Bayrak G, Buker N. Distance learning in the COVID-19 pandemic: acceptance and attitudes of physical therapy and rehabilitation students in Turkey. Rural and remote health. 2021;21.8-1:(4)\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCampbell D, Allen B, Hooper T, Domenech M, Manella K. Doctor of Physical Therapy students\u0026rsquo; clinical reasoning readiness and confidence treating with telehealth: a United States survey. The Journal of Clinical Education in Physical Therapy. 202.4;2\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMaheu MM, Drude KP, Hertlein KM, Hilty DM. A framework of interprofessional telebehavioral health competencies: Implementation and challenges moving forward. Academic Psychiatry. 2018 Dec;42(6):825\u0026thinsp;\u0026minus;\u0026thinsp;33.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKirkpatrick D, Kirkpatrick J. Evaluating training programs: The four levels. Berrett-Koehler Publishers; 2006.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBenner P. Using the Dreyfus model of skill acquisition to describe and interpret skill acquisition and clinical judgment in nursing practice and education. Bulletin of science, technology \u0026amp; society. 2004 Jun;24(3):188\u0026thinsp;\u0026minus;\u0026thinsp;99.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Telehealth, Attitude, Experience, Paramedical Students","lastPublishedDoi":"10.21203/rs.3.rs-5974342/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5974342/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eIntroduction:\u003c/h2\u003e \u003cp\u003eTelehealth refers to the use of telecommunication technologies to deliver healthcare services, provider and patient education, and information. Paramedical students\u0026rsquo; perspectives are key, as their readiness affects the future success of telehealth in clinical practice. Therefore, the aim of this study is to investigate the attitudes and experiences of paramedical students toward telehealth.\u003c/p\u003e\u003ch2\u003eMaterials and Methods\u003c/h2\u003e \u003cp\u003eThis cross-sectional quantitative study was conducted from October 2024 to February 2025. Data were collected using a previously validated questionnaire developed by Rettinger et al. (2024). The questionnaire consisted of 18 items that addressed demographic information, respondents\u0026rsquo; ICT competence, interest in telehealth, perceived knowledge, the importance and applications of telehealth, previous telehealth experiences, and three open-ended questions exploring students\u0026rsquo; perspectives on telehealth. The questionnaire was administered online. A survey link was emailed to eligible students who had expressed interest in participating. Completing the survey took approximately 15 minutes. To ensure validity, the face validity of the questionnaire was reviewed by five faculty members. Reliability was evaluated through the test-retest method over a 10-day interval, yielding a Cronbach\u0026rsquo;s alpha of 0.78. Data were analyzed using SPSS version 16.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eA total of 132 students responded to the survey (response rate: 100%). 72.7% of the students were very or relatively interested in telehealth. 77.3% considered telehealth important during their studies. However, only 11.4% reported actual experience with telehealth programs in their field. The Kruskal-Wallis H test showed significant differences across education levels in terms of perceived knowledge (P\u0026thinsp;=\u0026thinsp;.014) and perceived importance of telehealth in education (P\u0026thinsp;=\u0026thinsp;.042).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eDespite high levels of interest and generally positive attitudes, students reported limited experience and exposure of telehealth. These findings highlight the importance of integrating telehealth education into paramedical training.\u003c/p\u003e","manuscriptTitle":"Attitudes and Experience of Paramedical Students Toward Telehealth in Education, A Cross-Sectional Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-04-18 11:07:25","doi":"10.21203/rs.3.rs-5974342/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-06-16T06:52:48+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-06-10T22:08:14+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"220409159590451896871423218093839803304","date":"2025-06-10T22:01:30+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-06-10T13:43:49+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"20902908573847423682015407304800897152","date":"2025-04-25T20:42:56+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-04-18T01:03:51+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"305884494075996646222745369078170606959","date":"2025-04-17T20:10:00+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-04-17T11:31:33+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-04-16T11:47:40+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Medical Education","date":"2025-04-10T07:52:42+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"5dd8752b-a9fd-4261-a1ff-f1e6fbc542a1","owner":[],"postedDate":"April 18th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-07-28T16:08:47+00:00","versionOfRecord":{"articleIdentity":"rs-5974342","link":"https://doi.org/10.1186/s12909-025-07712-8","journal":{"identity":"bmc-medical-education","isVorOnly":false,"title":"BMC Medical Education"},"publishedOn":"2025-07-22 15:57:59","publishedOnDateReadable":"July 22nd, 2025"},"versionCreatedAt":"2025-04-18 11:07:25","video":"","vorDoi":"10.1186/s12909-025-07712-8","vorDoiUrl":"https://doi.org/10.1186/s12909-025-07712-8","workflowStages":[]},"version":"v1","identity":"rs-5974342","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5974342","identity":"rs-5974342","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}